重型肝炎患者血清TNF-α的变化及临床意义

Serum TNF-α Changes in Severe Hepatitis Patients and the Clinic Value

目的 通过观察各期重型肝炎患者血清TNF -α的水平及其在ALSS治疗前后的变化 ,探讨TNF -α在重型肝炎发病中的作用机制及临床意义。方法 设重型肝炎组、急性肝炎组、慢性肝炎组、肝炎后肝硬化组和正常对照组 ,测定每组血清TNF -α、内毒素、TGF - β1的水平 ,以及重型肝炎组患者血清TNF -α、内毒素、TGF - β1在ALSS治疗前后的水平。结果 重型肝炎组患者血清TNF - (等炎性因子水平明显高于急性肝炎组、慢性肝炎组、肝炎后肝硬化组和正常对照组。ALSS治疗后 ,重型肝炎患者血清TNF -α等炎性因子明显低于治疗前水平。TNF -α逐渐下降的重型肝炎患者 ,病情逐渐好转。结论 高水平的TNF -α在重型肝炎患者肝细胞损伤中起着重要作用 ,ALSS治疗可清除TNF -α ,对重型肝炎有明显疗效。血清TNF

Objective To investigate the mechanism and clinic value of TNF-α in SH, based on the observation of serum level of TNF-α in patients with various stages of SH and the change of serum level of TNF-α in SH after the therapy of ALSS.Methods Patients were divided into groups with severe hepatitis、acute hepatitis、chronic hepatitis、hepatic cirrhosis after hepatitis and control group. The serum level of TNF-α、 endotoxin and TGF-β 1 were detected in every group as well as severe hepatitis group before and after the therapy of ALSS.Result The level of serum TNF-α、endotoxin、and TGF-β 1 was notably higher than that in acute hepatitis group、chronic hepatitis group、control group, and decreased obviously after the therapy of ALSS(p<0.05). Clinical condition of patients whose serum level of TNF-α decreased gradually improved step by step in severe hepatitis group.Conclusion High level of TNF-α in serum plays an important role in hepatocyte damage of severe hepatitis. ALSS can remove TNF-α. The changes of serum TNF-α level in patients with severe hepatitis can be used to judge the severity and the prognosis of severe hepatitis.