重型肝炎患者血清皮质醇水平的研究  

Decreased expression of serum cortisol in patients with severe hepatitis

作　　者：高岭[1] 王凯[1] 王介非[2] 张正国 范玉琛[1] 葛剑[1] 蔡森[3] 

机构地区：[1]山东大学齐鲁医院肝病科,山东大学肝病研究所,济南250012 [2]上海市复旦大学附属公共卫生临床中心重症肝炎ICU科 [3]中国人民解放军第456医院肝病科

出　　处：《中华实验和临床病毒学杂志》2010年第1期36-38,共3页Chinese Journal of Experimental and Clinical Virology

基　　金：国家“十一五”重大专项基金资助（基金编号2008ZX10002-007）

摘　　要：目的 探讨病毒性重型肝炎患者血清皮质醇浓度的变化.方法 应用放射免疫法测定50例病毒性肝炎患者血清皮质醇浓度.其中重型肝炎患者30例,慢性乙型肝炎患者20例.同时检测患者肝功能、PTA等实验室指标.结果 重型肝炎患者组血清皮质醇浓度较慢性乙型肝炎患者组低（P〈0.05）,较正常对照组低（P〈0.05）;在重型肝炎患者中,血清皮质醇浓度与PTA呈显著正相关（r=0.445,P〈0.05）,重型肝炎患者血清皮质醇浓度与患者血清ALT无明显相关性（P〉0.05）,与AST/ALT比值呈显著负相关（r=-0.367,P〈0.05）,与患者血清总胆红素无明显相关性（P〉0.05）;重型肝炎患者死亡组的血清皮质醇浓度明显低于存活组（P〈0.05）;对重型肝炎患者进行MELD评分,MELD分值越高组,皮质醇浓度越低.结论 重型肝炎患者皮质醇浓度降低,其与肝脏功能损害、病情严重程度有关,皮质醇水平与患者预后有关.Objective To investigate the profile of serum cortisol levels in patients with severe hepatitis. Methods Fifty patients with viral hepatitis（including 30 severe hepatitis patients and 20 chronic hepatitis B. patients） were enrolled in this present study. Serum cortisol concentration was tested using radioimmunoassay. Furthermore, liver function, coagulation and other related laboratory indices were also determined. Results Serum cortisol concentration of severe hepatitis group was lower than that of chronic hepatitis B. group （P〈0.05） and lower than that of healthy controls （P〈0.05）. serum cortisol concentration of severe hepatitis patients was significantly positively correlated with PTA （r=0.445, P〈 0.05）;serum cortisol concentration has no relation with ALT in patients with severe hepatitis（P〉0.05）, and serum cortisol concentration was significantly negatively correlated with the ratio of AST/ALT in patients with severe hepatitis（r=-0.367, P〈0.05） ;No significant relationship was found between serum cortisol concentration and total Bilirubin（P〉0.05） ;Serum cortisol concentration in death group of severe hepatitis was lower than that in survival group of severe hepatitis（P〈0.05） ;Of severe hepatitis patients with MELD score, the higher MELD score, the lower the cortisol concentration. Conclusion Cortisol concentration decreased in patients with severe hepatitis, which was related to functional liver reserve and disease severity. Cortisol can be related to the prognosis of severe hepatitis patients.

关 键 词：肝炎 可的松 预后 

分 类 号：R575.1[医药卫生—消化系统] R817.4[医药卫生—内科学]