慢性重型乙型肝炎血清GM-CSF测定及其意义

The Significance of Serum Granulocyte-Macrophage Colony Stimalating Factor in Chronic Severe Hepatitis B

目的 :探讨粒细胞巨噬细胞集落刺激因子 (granulocyte macrophagecolonystimulatingfactor,GM CSF)和肿瘤坏死因子 (tumornecrosisfactor,TNF α)之间的相关性及其在重型乙型肝炎发病中的作用。方法 :应用酶联吸附试验(ELISA)同期检测重型乙型肝炎、慢性乙型肝炎和健康献血员各 2 0例。结果 :GM CSF和TNF α水平与对照组比较 ,重型肝炎组和慢性肝炎组血清GM CSF水平分别升高至 9.8± 1.2 3(P <0 .0 5 )和 8.36± 1.89(P <0 .0 5 )。在重型肝炎组中 ,血清GM CSF水平与TNF α水平 (r=0 .4 2 6 8,P <0 .0 5 )呈显著正相关。结论 :GM CSF与重型乙型肝炎发病关系密切 ,其机制可能与内毒素血症密切相关 ;GM CSF在慢性乙型肝炎肝损害中能起到免疫激活作用 ,通过激活免疫反应 。

Objective: To investigate granulocyte macrophage colony stimulating factor(GM GSF) and tumor necrosis factor(TNF) in pathogenesis severe hepatitis and possible relationship between them. Methods: GM GSF and TNF α by ELISA were measured in seris of 20 patinets with severe hepatitis, 20 patients with chronic hepatitis and 20 healthy blood donor. Results: Serum level of GM GSF were elevated to 9.8±1.23 and 8.36±1.89 in patients of severe hepatitis (SH) and chronic hepatitis (CH) compared with control respectively (P<0.05). In patents of SH, a significantly positive correlation between GM GSF and TNF α(r=0.426 8, P<0.05) could be observed, a markedly negative correlation between GM GSF and albumin(r=-0.419 6, P<0.05) was found. In CH, a positive correlation between GM GSF and alanine transaminase(r=0.599 6, P<0.05)was found. Conclusion: These results suggest the following: ① GM GSF may be involved in pathogenesis of SH, its mechanism is possibly related to endotoxin. ② In CH, GM GSF may indirectly injure hepatocyte through activating immune response.