【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。更多还原

【Abstract】 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.更多还原