肿瘤坏死因子在重型肝炎发病中的作用

A STUDY OF SERUM TUMOR NECROSIS FACTOR ACTIVED LEVEL IN DIFFERENT CLINICAL TYPE HEPATITIS B CASES

目的 探讨TNF α在肝炎发病中的作用及重症肝炎患者血清内毒素水平与TNF α活性水平之间的关系。方法 选择不同临床类型的肝炎患者 84人 ,正常对照组 18人 ,比较各型患者血清TNF α活性 ,并就血清内毒素水平与TNF α活性水平之间的关系进行了研究。结果 TNF α活性水平在各组间总的差别有显著性 (F =2 1.53,P <0 .0 1) ,呈现出重症肝炎 >CH(重 ) >CH(中 ) >CH(轻 ) >肝硬化 >AH ;且重症肝炎组明显高于其他各组 (P均 <0 .0 1) ,其它各组间差别无显著性。慢性乙肝 (重度 )合并G- 杆菌感染者和TNF α活性与内毒素水平呈正相关 (r =0 .9111,P >0 .0 5)。结论 TNF α可能参与了重症肝炎的发生 ,内毒素通过刺激单核巨噬细胞产生大量TNF α促进肝细胞的坏死。

Objective To further evaluate tumor necrosis factor's action in hepatitis B infection course and relationship between serum Endortoxin and TNF actived level in grave CH.Methods 84 different clinical hepatitis B infection cases and 18 normal persons(control groups) were chosen as study subjects,analysis of serum TNF actived level in different clinical type hepatitis B infection cases and relationship between serum Endortoxin and TNF actived level in grave CH were carried out.Result There was singnificant difference in TNF actived level between the different groups(F=21.53,P<0.01).The results revealed that grave hepatitis>chronic hepatitis(high degree>middel degree>gravity degree)>acute hepatitis.The grave hepatitis group was more singnifficant than other groups(P<0.01),but between any other groups there was no singnificant difference,and regression analysis showed that there was good correlation between the TNF actived level and Endotoxin level in chronic CH co infection G - bactierum.Conclusion There was a correlation between grave hepatitis B infection and TNF Endortoxin can enhance hepatocellular necrosis producing more TNF by means of stimulated T Lympthatic cells.