肿瘤坏死因子-α、白介素-6在脓毒症患者肝功能评估中的价值

Value of tumor necrosis factor-α,interleukin-6 in liver function assessment of patients with sepsis

目的探讨肿瘤坏死因子(TNF)-α、白介素(IL)-6在脓毒症患者肝功能评估中的应用价值。方法选取2013年7月至2015年7月湖南省人民医院急诊科和湖南省长沙市中心医院急诊科收治的83例脓毒症伴肝功能异常患者作为研究对象,并根据患者肝功能异常程度分为轻度组(26例)、中度组(30例)和重度组(27例),另选取同期健康体检者30例作为对照组。分别检测各组研究对象血清TNF-α、IL-6水平,并分析血清TNF-α、IL-6水平与肝功能的关系。结果各组脓毒症患者血清TNF-α、IL-6水平较对照组明显升高,差异均有统计学意义(P<0.05);随肝功能异常程度加重,血清TNF-α、IL-6水平进行性升高,轻、中、重度组比较,差异均有统计学意义(P<0.05);脓毒症伴肝功能异常患者血清TNF-α、IL-6水平与血清丙氨酸氨基转移酶、天门冬氨基酸氨基转移酶、总胆红素均呈正相关(P<0.05),与清蛋白均无关(P>0.05)。结论血清TNF-α、IL-6水平与脓毒症患者肝功能异常程度密切相关,可作为肝功能评估指标。

Objective To explore the applicable value of serum tumor necrosis factor-α（TNF-α） and interleukin-6（IL-6）levels on the liver function assessment in the patients with sepsis. Methods Totally 83 cases of sepsis complicating liver function abnormality in the emergency department of our two hospitals from July 2013 to July 2015 were selected as the research subjects and divided into the mild group（26 cases）,moderate group（30 cases） and severe group（27 cases） according to the liver function abnormality degree. Other contemporaneous 30 individuals undergoing the healthy physical examinations were selected as the control group. The serum TNF-α and IL-6 levels were detected in each group and its relationship with the liver function was analyzed. Results Compared with control group,the TNF-α and IL-6 levels in various sepsis groups were significantly increased with statistical difference（P〈0.05）;with the liver function abnormality aggravation,the serum TNF-α and IL-6 levels were progressively elevated,which had statistical difference among the mild,moderate and severe groups（P〈0.05）;serum TNF-α and IL-6 levels in the sepsis patients with liver function abnormality had positive correlation with serum ALT,AST and TBIL（P〈0.05）,and no correlation with ALB（P〈0.05）. Conclusion Serum TNF-α and IL-6 levels are closely correlated with the degree of liver function abnormality,which can be used as the indicators for assessing the liver function.