慢性重型肝炎患者早期血清IL-18和NO水平变化及N-乙酰半胱氨酸对其的影响  

Serum level of Interlukin 18 and nitric oxide and the effect of N-acetylcysteine in patients with fulminant hepatic failure

作　　者：潘红英[1] 娄国强[1] 赵年丰[1] 童永喜[1] 吴惟一[1] 卢德荣[1] 俞秀丽[1] 王宇芳[1] 

机构地区：[1]杭州市第六人民医院,310014

出　　处：《中华传染病杂志》2004年第3期177-179,共3页Chinese Journal of Infectious Diseases

基　　金：浙江省杭州市科委资助项目 (2 0 0 12 3B2 8)

摘　　要：目的　探讨白细胞介素 18(IL 18)、一氧化氮 (NO)在慢性重型病毒性肝炎 (慢重肝 )早期中的作用以及N 乙酰半胱氨酸 (NAC)治疗慢重肝早期对IL 18和NO水平的影响。方法　采用夹心酶联免疫吸附法分析 6 5例慢重肝早期患者血清IL 18和NO的水平表达及动态变化 ;通过NAC治疗 2 9例与单用综合治疗 36例的自身治疗前、后及治疗后两组中疗效的对比 ,观察IL 18和NO水平表达的变化及影响。结果　慢重肝早期患者血清IL 18、NO水平分别为 :NAC组 :( 2 5 9.4 1±13.79) pg/ml,( 191.5 7± 6 .95 ) μmol/ml;综合治疗组 :( 2 6 4 .97± 18.91) pg/ml,( 2 0 6 .17± 10 .16 )μmol/ml,明显高于健康对照组 [IL 18:( 84 .93± 2 .5 9)pg/ml,NO :( 6 0 .74± 4 .2 5 ) μmol/ml],差异有显著性 (P <0 .0 0 1)。NAC组经治疗后上述两项指标的水平分别是 ( 136 .86± 17.6 3) pg/ml,( 112 .34±12 .5 7) μmol/ml,比治疗前明显下降 ,差异有显著性 (P <0 .0 0 1)。NAC组治疗后有效组IL 18、NO水平由治疗前 ( 2 74 .89± 16 .92 ) pg/ml,( 196 .30± 6 .10 ) μmol/ml分别下降至 ( 97.6 7± 17.11)pg/ml,( 74 .18± 4 .86 ) μmol/ml;而无效组则由治疗前 ( 2 18.78± 16 .81) pg/ml,( 179.17± 19.75 ) μmol/ml分别升高至 ( 2Objective To investigate whether there is a correlation of serum interleukin 18 (IL 18) and nitric oxide (NO) with Fulminant Hepatic Failure(FHF) and the effect of N acetylcysteine (NAC) on IL 18 and NO levels. Methods The level expression and dynamic changes of serum IL 18 and NO in 65 FHF patients serum were measured by ELISA. IL 18 and NO and their expression levels were observed comparatively in NAC treatment group (29 cases) and composite treatment group (36 cases). Results Serum IL 18 and NO concentrations in patients with FHF in both groups (NAC and Combination) were significantly higher than the control ( P <0.001). A significant reduction of IL 18, NO was observed in the patients after NAC treatment [(259.41±13.79) vs (136.86±17.63) pg/ml, (191.57±6.95) vs (112.34±12.57) μmol/ml, P <0.001. Serum IL 18 and NO in the effective group to the NAC therapy were decreased significantly after the treatment [(274.89±16.92) vs (97.67±17.11) pg/ml; (196.30±6.10] vs (74.18±4.86) μmol/ml, P <0.05). Serum IL 18 and NO in the non effective group to the NAC therapy were risen significantly after the treatment [(218.78±16.81) vs (239.76±14.98) pg/ml, (179.17±19.75) vs (212.50±11.59) μmol/ml, P <0.05]. Conclusions IL 18 and NO were related with FHF and could be decreased after NAC treatment.

关 键 词：慢性重型肝炎 血清 IL-18 NO N-乙酰半胱氨酸 一氧化氮 

分 类 号：R512.6[医药卫生—内科学]