Leptin TNF—a IL-6在自发性SBP患者中的变化及临床意义

目的观察瘦素（Leptin）、肿瘤坏死因子d（TNF．d）和白细胞介素-6（IL-6）在自发性细菌性腹膜炎（SBP）患者血清、腹水中的表达，并探讨其临床意义。方法肝硬化腹水患者82例，随机分为SBP组42例和非SBP组40例，SBP组患者根据预后分为好转组25例和恶化组17例，比较各组患者血清和腹水Leptin、TNF-a、IL-6表达水平。结果SBP组患者治疗前血清和腹水Leptin、TNF—a、IL-6表达水平明显高于非SBP组（P〈O．05），经抗感染治疗后，SBP组患者血清和腹水Leptin、TNF—a、IL-6表达水平较治疗前均明显降低（P〈0．05）；好转组血清和腹水Lcptin、TNF-a、IL-6表达水平明显低于恶化组（P〈O．05）；SBP组患者血清及腹水Leptin与TNF-d、IL-6变化呈正相关（P〈0．05）。结论血清和腹水Leptin、TNF-a、IL-6表达可作为早期诊断SBP和判断患者预后情况的实验室指标。

Objective To observe the expression of Leptin, tumor necrosis factor aLeptinha （ TNF- a ） and interleukin-6 （ IL-6 ） in serum and ascites of patients with spontaneous bacterial peritonitis （ SBP ） , and to explore its clinical significance. Methods 82 patients with cirrhosis ascites were randomly for SBP group （ n=42 cases ） and non-SBP group （ n=40 cases ） , SBP group was individed to improved group （ 25 cases ） and deterioration group （ 17 cases ） according to the prognosis. The expression level of Leptin, TNF aLeptinha, IL-6 in patient＇s serum and ascites were compared. Results The Leptin, TNF aLeptinha, IL-6 expression levels in serum and ascites on SBP group before treatment were significantly higher than that of non-SBP group （P〈0.05） . After anti infection treatment, the Leptin, TNF aLeptinha, IL-6 expression levels in serum and ascites on SBP group were significantly lower than that of before treatment （ P〈0.05 ） . The Leptin, TNF aLeptinha, IL-6 expression levels in serum and ascites of improved group was significantly lower than that of deterioration group （ P〈0.05 ） . The expression level of Leptin in serum and ascites of SBP group had a positively related with TNF-a, IL-6 changes （ P〈0.05 ） . Conclusion The expression of IL-6, TNF- a and Leptin in serum and ascites can be used as laboratory markers for early diagnosis of SBP and prognosis of patients.