乙肝后肝硬化患者血清IL-1β、TNF-α变化对骨代谢影响的临床研究

Clinical Study of Serum IL-1β、TNF-αon Bone Metabolism in Patients with Posthepatitic Cirrhosis

为探讨细胞因子对乙肝后肝硬化骨代谢的影响 ,采用RIA及ELISA分别测定 36例乙肝后肝硬化患者血清IL - 1β、TNF -α水平及骨密度测量 ,并与 15例健康者对照。结果表明 ,肝硬化患者血清IL - 1β、TNF -α水平较对照组显著升高 (P <0 0 0 1,P <0 0 0 1) ,其中骨质疏松 (OP)组较非骨质疏松 (NOP)组均升高明显 (P <0 0 0 1,P <0 0 1) ,且两组间Child -PughA、C级同级分别比较 ,血清IL - 1β水平显示差异 (P <0 0 1,P <0 0 5 ) ,血清TNF -α水平亦有差异 (P <0 0 5 ,P <0 0 5 ) ;OP组血清IL - 1β、TNF -α与尺桡密度均呈负相关 (r=0 6 38,P <0 0 1;r=0 483,P<0 0 5 ) ,而NOP组则呈无相关。提示乙肝后肝硬化患者血清IL - 1β、TNF -α水平升高 ,是肝性骨病 (HBD)发生的重要因素 ,降低体内IL - 1β、TNF -α水平对HBD防治有一定意义。

To discuss the influence of cytokines on bone metabolism in patients with posthepatitic cirrhosis,levels of serum IL-1β、TNF-α were detected by radioimmunoassay and enzyme-linked immunosorbent assay respectively in 36 male cirrhosis and 15 age-matched healthy controls The result showed that serum IL-1β、TNF-α in cirrhosis increased more than that of controls (P<0 001,P<0 001),and osteoporosis (OP) groups much higher than non-osteoporosis(NOP)groups(P<0 001,P<0 01) In Child-Pugh Class A and C,the levels of serum IL 1β( P<0 05,P<0 01)and TNF-α(P<0 005,P<0 005)were significant difference between OP group and NOP group We also found IL-1β and TNF-α had negative correlation with mean ulnoradial density(r=0 638,P<0 01;r=0 438,P<0 05) It was suggested that elevation of serum IL-1β and TNF-α can accelerate bone resorption and lead to hepatic bone disease(HBD) Reducing the concentration and blocking the effect of IL-1β and TNF-α may be very important for prevention and treatment of HBD