肝硬化并自发性腹膜炎患者血清及腹水瘦素、肿瘤坏死因子-α、白细胞介素-6临床意义的探讨  

Changes and clinical signficance of leptin,TNF-α and IL-6 in serum and ascites of patients with hepatic cirrhosis complicated with spontaneous bacterial peritonitis

作　　者：梁坚[1] 吴康英[2] 周宇[1] 余权珍[1] 黄红[3] 

机构地区：[1]广东医学院附属医院消化内科消化内科,广东湛江524001 [2]广东医学院附属医院消化内科内镜中心,广东湛江524001 [3]广东医学院附属医院消化内科同位素科室,广东湛江524001

出　　处：《中西医结合肝病杂志》2009年第5期278-280,共3页Chinese Journal of Integrated Traditional and Western Medicine on Liver Diseases

摘　　要：目的:探讨肝硬化并发自发性腹膜炎(SBP)患者血清及腹水中瘦素、肿瘤坏死因子(TNF-α)、白细胞介素(IL-6)水平的变化和临床意义。方法:采用放射免疫法测定67例肝硬化腹水患者(SBP组32例,漏出液组35例)血清及腹水瘦素水平,同时采用双抗体夹心ELISA法测定血清及腹水的TNF-α、IL-6水平。结果:SBP组患者血清及腹水瘦素、TNF-α、IL-6水平明显高于漏出液组(P<0.01),且腹水瘦素、TNF-α、IL-6又高于血清中的水平(P<0.01或P<0.05);感染控制后,血清和腹水中瘦素、TNF-α、IL-6水平明显降低(P<0.01或P<0.05);SBP组治疗无效者初始血清和腹水中瘦素、TNF-α、IL-6水平明显高于治疗有效者(P<0.01或P<0.05);肝硬化患者血清和腹水中瘦素与TNF-α、IL-6变化呈正相关。结论:肝硬化并发SBP患者血清和腹水中的瘦素、TNF-α、IL-6明显升高,临床上检测血清和腹水的瘦素、TNF-α、IL-6水平对SBP的早期诊断、疗效判断及预后评估均有一定意义。Objective： To investigate the changes and clinical signficance of leptin, TNF-α and IL-6 in serum and ascites of patients with hepatic cirrhosis complicated with spontaneous bacterial peritonitis （SBP） . Methods： Leptin levels from serum and ascitic were measured in 67 patients with hepatic cirrhosis （ among them complicated with SBP 32 and transudate group 35 ） by immunoradiometric assay, and the levels of TNF-α and IL-6 were measured by ELISA. Results： The serum and ascitic levels of leptin, TNF-α and IL-6 of SBP group were signifcantly higher than those of the transudate group （ P 〈 0.01 ） . In SBP group, the level of leptin, TNF-α and IL-6 in ascites were higher than those in the serum （ P 〈 0. 05 to 0. 01 ） . After the abdmoinal cavity infection was controlled, the level of leptin, TNF-α and IL-6 in the serum and ascites decreased （P 〈 0. 05 to 0. 01 ） . The level of leptin, TNF-α and IL-6 in the serum and ascites of patients who were sensitive to anti-infection therapy were lower than those of ones who were not sensitive to first anti-infection therapy （P 〈0. 05 to 0.01 ） . Serum and ascites leptin level was positively correlated with TNF-α and IL-6. Conclusion： When cirrhosis complicated with SBP, the level of leptin, TNF-α and IL-6 in the serum and ascites of patients increase. Measurement of leptin, TNF-α and IL-6 in the serum and ascites is helpful for early diagnosis and judgement of effectiveness and prognosis of SBP in liver cirrhosis.

关 键 词：肝硬化 自发性腹膜炎 瘦素 肿瘤坏死因子-Α 白细胞介素-6 

分 类 号：R575.2[医药卫生—消化系统]