人工肝支持系统对重型肝炎患者血清细胞因子影响的研究  

Research on influence of artificial liver system to serum cytokine of severe hepatitis patients

作　　者：李勇忠[1] 符政远[1] 蒋建勇[1] 邓英[1] 彭吉军[1] 胡文祥[1] 李淮[1] 于红缨[1] 

机构地区：[1]湖南省怀化市第一人民医院,湖南怀化418000

出　　处：《中国医学工程》2006年第5期466-468,472,共4页China Medical Engineering

摘　　要：目的观察人工肝支持系统对重型肝炎肝衰竭患者血清白介素-(2IL-2)、白介素-(6IL-6)、转化生长因子β(1TGFβ1)、肿瘤坏死因子(TNF-α)及内毒素(LPS)的清除效果,进一步探讨人工肝支持系统在重型肝炎治疗中的意义。方法36例重型肝炎患者分别在血浆置换(PE)、连续静脉血液滤过(CVVH)等人工肝支持系统不同方法的治疗前后测定患者血清IL-2、IL-6、TGFβ1、TNF-α及LPS的水平,比较它们在治疗前后的变化。结果36例患者PE治疗前血清中IL-2(28.75±12.43)pg/mL、IL-6(54.26±19.28)pg/mL、TGFβ1(30.70±26.90)ng/mL、TNF-α(88.17±46.32)pg/mL、LPS(0.86±0.45)Eu/mL,PE治疗后IL-2(35.30±14.18)pg/mL、IL-6(46.42±18.73)pg/mL、TGFβ1(18.56±13.77)ng/mL、TNF-α(64.54±30.25)pg/mL、LPS(0.53±0.28)Eu/mL;CVVH治疗前IL-2(30.26±12.69)pg/mL、IL-6(52.90±20.42)pg/mL、TGFβ1(28.58±16.70)ng/mL、TNF-α(82.35±41.66)pg/mL、LPS(0.80±0.38)Eu/mL,CVVH治疗后IL-(236.98±15.20)pg/mL、IL-6(35.85±18.16)pg/mL、TGFβ1(15.16±7.92)ng/mL、TNF-α(46.70±20.44)pg/mL、LPS(0.59±0.31)Eu/mL。PE及CVVH治疗后血清IL-6、TGFβ1、TNF-α及LPS均下降,而IL-2却上升,其比值差异均有显著性。结论PE及CVVH治疗后对IL-6、TGFβ1、TNF-α、内毒素均有不同程度的清除作用,而IL-2却有一定程度的升高,从而减轻免疫反应对肝细胞的损害,有助于改善重型肝炎肝衰竭患者的预后。[Objective] To observe the effect of artificial liver system to eliminate serum interleukin-2 （IL-2）, interleukin-6 （IL-6）, transforming growth factorβ1 （TGFβ1）, tumor necrosis factor （TNF-α）, and lipopolysaccharide （LPS） of severe hepatitis, and discuss the significance of artificial liver system to the treatment of severe hepatitis patients. [Methods] Serum IL-2, IL-6, TGFβ1, TNF-α and LPS of 36 severe hepatitis patients were determined before and after the treatment of plasma exchange （PE）, continuous veno-venous hemofiltration （CVVH） etc. respectively, and compared the levels of these cytokines before the treatment with that after the treatment. [Results] The levels before the treatment of PE were as followed： IL-2（28.75±12.43） pg/mL, IL-6（54.26±19.28） pg/mL, TGFβ1 （30.70±26.90） ng/mL, TNF-α（88.17±46.32）pg/mL, LPS（0.86±0.45） Eu/mL; The levels after the treatment of PE were as followed： IL-2（35.30±14.18） pg/mL, IL-6（46.42±18.73） pg/mL, TGFβ1（18.56±13.77） ng/mL, TNF-α（64.54± 30.25） pg/mL, LPS（0.53±0.28） Eu/ml; The levels before the treatment of CVVH were as followed： IL-2 （30.26± 12;69）pg/mL, IL-6（52.90±20.42） pg/mL, TGFβ1（28.58±16.70） ng/mL, TNF-α（82.35±41.66） pg/mL, LPS （0.80±0.38） Eu/mL; The levels after the treatment of CVVH were as followed： IL-2（36.98±15.20） pg/mL, IL-6（35.85±18.16） pg/ mL, TGFβ1 （15.16±7.92） ng/ml, TNF-α（46.70±20.44） pg/mL, LPS（0.59±0.31） Eu/mL. Serum IL-6, TGFβ1, TNF- α and LPS were decreased, however, IL-2 was increased after the treatment of PE, CVVH, and there were significant difference between the levels. [Conclusion] IL-6, TGFβ1, TNF-α and LPS are eliminated to some extent after the treatment of PE, CVVH, however, IL-2 is increased to some extent, which alleviate the damage to liver cells caused by immunoreaction, and improve the prognosis of severe hepatitis, hepatic failure patients.

关 键 词：重型肝炎 人工肝支持系统 血清白介素-2 白介素-6 转化生长因子 肿瘤坏死因子 内毒素 

分 类 号：R318.14[医药卫生—生物医学工程]