乙型肝炎肝硬化合并肝性脑病患者血清LPS、TNF-α和IL-6的表达变化及意义  

Changes of expression of serum LPS, TNF-α and IL-6 in patients with hepatitis B-related cirrhosis complicated with hepatic encephalopathy and its significance

作　　者：王柯尹[1] 吴一鸣[1] 陆许贞[1] 邹卓林 卢明芹[2] 

机构地区：[1]浙江省嘉兴市第一医院感染科,浙江嘉兴314000 [2]温州医学院附属第一医院感染科,浙江温州325000

出　　处：《中国现代医生》2017年第10期12-15,共4页China Modern Doctor

基　　金：浙江省自然科学基金项目(LY12H03002);浙江省嘉兴市科技计划项目(2016BY28006);浙江省温州市科技计划项目(Y20140669)

摘　　要：目的检测乙型肝炎肝硬化合并肝性脑病(hepatic encephalopathy,HE)患者血清中内毒素(LPS)、肿瘤坏死因子-α(TNF-α)和白细胞介素(IL)-6水平,探讨其表达变化及意义。方法选择2014年8月~2016年8月在嘉兴市第一医院住院的患者90例,将68例乙肝肝硬化合并肝性脑病的患者设为A组,其中25例临床分级0级为A1组,25例1~2级为A2组,18例3~4级为A3组,22例乙肝肝硬化患者为B组,20例健康体检者为正常对照组(C组)。检测研究对象血清中LPS、TNF-α和IL-6水平,并分析其与TBil、ALT、AST、ALB、血氨的相关性。结果 A组患者血氨浓度较B组、C组升高,差异有统计学意义(P<0.05)。血清LPS[(266.6±85.2)ng/L]、TNF-α[(41.9±7.0)μg/L]、IL-6[(48.9±10.3)ng/L]水平均明显高于B组[LPS:(121.4±24.1)ng/L;TNF-α:(28.3±4.6)μg/L;IL-6:(32.6±8.5)ng/L]和C组[LPS:(24.2±5.1)ng/L;TNF-α:(19.0±3.4)μg/L;IL-6:(16.8±4.9)ng/L],差异有统计学意义(F=112.6、127.05、103.24,P<0.05)。A1、A2、A3组LPS、TNF-α和IL-6、血氨水平逐渐升高,各组相比,差异有统计学意义(F=87.94、25.39、26.95、11.67,P<0.05)。血清LPS、TNF-α和IL-6水平均与血氨浓度呈正相关(r=0.267、0.322、0.311,P<0.05),与TBil、ALT、AST、ALB无明显相关性(P>0.05)。结论 LPS、TNF-α和IL-6是HE发生发展中重要的炎症介质,参与HE的免疫调节过程,分析其水平及变化可能有助于HE的病情判断及预后评估。Objective To investigate the levels of LPS, tumor necrosis factor-or （TNF-α） and interleukin （IL）-6 in the serum of the patients with hepatitis B-related cirrhosis complicated with hepatic encephalopathy（HE）, and to explore its expression changes and significance. Methods A total of 90 patients who were admitted to Jiaxing First Hospital from August 2014 to August 2016 were selected. 68 patients with hepatitis B-related liver cirrhosis complicated with hepatic encephalopathy were selected as group A. Among them, 25 patients with clinical grading of 0 were assigned to group A1, 25 patients with grading of 1 to 2 were assigned to group A2, and 18 patients with grading of 3 to 4 were assigned to group A3.22 patients with hepatitis B-related liver cirrhosis were assigned to group B, and 20 healthy subjects were assigned to the normal control group, as group C. The levels of LPS, TNF-α and IL-6 in the serum of research subjects were measured, and their correlations with TBil, ALT, AST, ALB and blood ammonia were analyzed. Results The blood ammonia concentration in group A was higher than that in group B and C, and the difference was statistically signifi- cant （P〈0.05）. The levels of serum LPS [（266.6±85.2） ng/L], TNF-α [（41.9±7.0） μg/L] and IL-6 [（48.9±10.3） ng/L] were significantly higher than those in group B [LPS： （121.4±24.1） ng/L; TNF-α： （28.3±4.6） μg/L; IL-6： （32.6±8.5） ng/L] and group C [LPS： （24.2±5.1） ng/L; TNF-α： （19.0±3.4） μg/L; IL-6： （16.8±4.9） ng/L]. The difference was statistically significant （F=112.6, 127.05, 103.24, P〈0.05）. The levels of LPS, TNF-α, IL-6 and blood ammonia in group A1, A2 and A3 were increased gradually, and the differences were statistically significant compared with those in other groups （F=87.94, 25.39, 26.95, 11.67, P〈0.05）. Serum LPS, TNF-α and IL-6 levels were positively correlated with blood am- monia concentration （r=0.267, 0.322, 0.311, P〈0.05）, but were not significantly c

关 键 词：肝性脑病 肿瘤坏死因子-α 白细胞介素-6 内毒素 

分 类 号：R277[医药卫生—中医学]