重型肝炎肝性脑病患者血氨和肿瘤坏死因子-α的相关性研究  

Relationship between tumor necrosis factor-alpha and ammonia in patients with hepatic encephalopathy due to severe hepatitis

作　　者：林希[1] 陈华忠[1] 王赓歌[1] 赵海红[1] 

机构地区：[1]温州医学院附属台州医院感染科,浙江临海317000

出　　处：《中国医师进修杂志》2008年第1期30-32,共3页Chinese Journal of Postgraduates of Medicine

摘　　要：目的 研究重型肝炎肝性脑病患者血氦和TNF-α的相关性。方法 采用ELISA法检测60例重型肝炎患者血清TNF-α含量，用酶法测定静脉血氦值。结果 在肝性脑病0级（15例）患者中血氨和，TNF-α分别是（39．1±6．5）μmol／L和（72．34±7．25）ng／L，Ⅰ级（10例）分别是（55.3±9．2）μmol／L和（91．25±10．16）ng／L，Ⅱ级（16例）分别是（82．5±12．5）μmol／L和（128．25±13．45）ng／L，Ⅲ级（13例）分别是（124．6±21．3）μmol／L和（155．38±19．76）ng／L，Ⅳ级（6例）分别是（198．3±36．7）μmol／L和（186.39±23.54）ng／L。血氨和TNF-α之间具有显著的相关性（r=0.68，P〈0．01），并且血氨和TNF-α与肝性脑病的严重程度具有明显的相关性（r=0.91，P〈0．01和r=0．85，P〈0．01）。结论 重型肝炎肝性脑病患者血氨和TNF-α具有显著的相关性，TNF-α可能参与肝性脑病的发病机制。Objective To study the relationship between TNF-α and ammonia in patients with hepatic encephalopathy （HE） due to severe hepatitis. Methods Sixty patients with severe hepatitis were studied,TNF-α concentrations were measured in venous serum using ELISA. Ammonia levels were determined in venous plasma by the enzymatic method. Results The values of circulating levels of ammonia and TNF- α in patients with grade 0 of HE （n = 15） were （39.1 ± 6.5） μmol/L and （72.34 ± 7.25）ng/L respectively, grade Ⅰ of HE （ n = 10） were （ 55.3 ± 9.2 ） μmol/L and （91.25 ± 10.16） ng/L respectively, grade Ⅱ of HE （n = 16） were （82.5 ± 12.5） μmol/L 和[1（128.25 ± 13.45）ng/L respectively,grade Ⅲ of HE （n = 13） were （ 124.6 ± 21.3） μmol/L 和（ 155.38 ± 19.76）ng/L respectively, and grade Ⅳ of HE （n = 6） were （ 198.3 ± 36.7 ）μmol/L 和（ 186.39 ± 23.54）ng/L respectively. A significant positive correlation was found between circulating levels of TNF- α and those of ammonia （r = 0.68, P 〈 0.01 ）, and also between circulating levels of both substances and severity of HE in these patients respectively （r = 0.91 ,P 〈 0.01 and r = 0.85,P 〈 0.01）. Conclusion The results of this study demonstrate a significant relationship between TNF-α and ammonia in patients with HE due to severe hepatitis, TNF-α may play a role in the pathogenesis of HE in these patients.

关 键 词：肝炎 肝性脑病 血氨 肿瘤坏死因子-Α 

分 类 号：R512.6[医药卫生—内科学] R747.9[医药卫生—临床医学] R446.6