急性胆道感染时肿瘤坏死因子与肝损坏关系的实验研究

An experimental study on the relationship between tumor necrosis factor and liver injury in acute biliary infection

目的:测定血中肿瘤坏死因子 - α(TNF- α)含量 ,以期用于急性胆道感染肝损坏的早期诊断 ,预测感染的严重程度及预后。方法:10 0只 Wistar大鼠 ,随机分为假手术组、胆总管结扎组、急性胆道感染组。 3组分别在术后6 h、12 h、18h和 2 4 h活杀取材 ,观察各时相点血清 TNF-α、血浆内毒素、肝脏血清谷丙转氨酶 (AL T)、谷草转氨酶(AST)的活性以及肝脏病理形态学的改变。结果:急性胆道感染组 TNF-α在术后 6 h已有显著提高 ,12 h、18h达分泌高峰 ;内毒素水平和肝脏 AL T及 AST的活性与 TNF-α均密切相关。同时 ,在肝脏病理形态上也有不同程度的改变。结论:急性胆道感染时 TNF-α是内毒素所致肝损害的主要原因之一 ,也可作为判断肝损害的早期诊断指标。

Objective: To evaluate measuring serum TNF α on practical significance for early diagnosis and forecasting the extent of serious infection in acute biliary infection. Methods: A handred Wistar rats were adopted in this experiment for control group, choledochal ligation group and acute obstructive cholangiotitis group. At the postoperative 6 th, 12 th, 18 th and 24 th hour, the parameters of each group were observed, which included serum TNF α,plasma endotoxin, the activity of hepatic ALT and AST, and hepatic histological changes. Result: TNF α maintained a higher level at 12th and 18th hour, and endotoxin and the activity of hepatic ALT and AST acted in close coordination with liver injury; the histologic changes of liver also appeared at different extent. Conclusion: TNF α is one of important causes of liver injury caused by endotoxin in acute biliary infection.