非生物型人工肝对重型肝炎患者血清细胞因子影响的研究  

Effect of non-bioartificial liver on serum cytokine levels 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] 马孝政[1] 谢知兵[1] 

机构地区：[1]湖南省怀化市第一人民医院感染科,湖南怀化418000

出　　处：《中国医师杂志》2006年第12期1633-1636,共4页Journal of Chinese Physician

基　　金：湖南省卫生厅医药基金资助项目(B2005170)

摘　　要：目的探讨血清细胞因子和非生物型人工肝在重型肝炎发病机制及治疗中的意义。方法测定正常组、重型肝炎保守治疗组及重型肝炎人工肝治疗组治疗前后血清IL-2、IL-6、TGFβ1、TNF-α、sFas、IFN-α的水平,并进行比较。结果人工肝治疗组和保守治疗组患者治疗前血清IL-2、IFN-α水平明显低于对照组(P<0.01),IL-6、TGFβ1、TNFα-、sFas水平明显高于对照组(P<0.01);人工肝治疗后血清IL-2、IFN-α水平较治疗前明显升高(P<0.05),IL-6、TGFβ1、TNF-α、sFas水平较治疗前明显下降(P<0.05)。保守治疗后血清IL-2、IL-6、sFas、IFN-α水平较治疗前变化不明显(P>0.05),TGFβ1、、TNF-α水平较治疗前下降(P<0.05)。死亡及疗效差自动出院的患者经人工肝治疗后血清细胞因子水平极易反弹,治愈及好转的患者经人工肝治疗后血清细胞因子水平不易反弹。结论非生物型人工肝对IL-6、TGFβ1、TNF-α、sFas有较好的清除作用,可使IL-2、IFN-α水平升高,对重型肝炎疗效明显。观察重型肝炎患者血清细胞因子水平对病情评估及预后有重要的临床意义。Objective To investigate the roles of cytokines and non-bioartificial liver in mechanism and clinical treatment of severe hepatitis. Methods Serum IL-2,IL-6 ,TGFβ1 ,TNF-α, sFas, IFN-αlevels of severe hepatitis patients before and after treatment with nonbioartificial liver were detected and compared. Results Serum IL-2 and IFN-odevels in severe hepatitis group before treatment were obviously lower than those of normal control group（ P 〈0. 001 ）, but IL-6 ,TGFβ1 ,TNF-α,sFas levels were obviously higher（ P 〈0. 001 ） ; Serum IL-2 and IFN-αevels in severe hepatitis group after treatment were obviously increased（ P 〈 0. 05 ）, but IL-6,TGFβ1, TNF-α, sFas levels were obviously decreased（ P 〈 0. 05 ）. Serum cytokines of patients with death and bad curative effect after treatment with artificial liver were very easy to be increased again. However, serum cytokines of patients with cure and improvement after treatment with artificial liver were not easy to be increased again. Conclusion Non-bioartificial liver can decrease the levels of IL-6,TGFβ1 ,TNF-α,sFas, while increase IL-2, IFN-α levels, and has obvious efficacy on severe hepatitis. It has important clinical significance to assess the serum cytokine levels to evaluate the pathological conditions and the prognosis of severe hepatitis.

关 键 词：肝 人工 肝炎 白细胞介素2 白细胞介素6 转化生长因子Β 干扰素Α 抗原 CD95 

分 类 号：R575.1[医药卫生—消化系统]