【作者】 李勇忠； 符政远； 邓英； 彭吉军； 胡文祥； 李淮； 于红缨； 蒋建勇； 马孝政； 谢知兵；

【Author】 LI Yong-zhong FU Zheng-yuan DENG Ying PENG Ji-jun HU Wen-xiang LI Huai YU Hong-ying JIANG Jian-yong MA Xiao-zheng XIE Zhi-bing.Department of infectious disease,the First Renmin Hospital of Huaihua,Hunan 418000,P.R.China

【机构】 湖南省怀化市第一人民医院；

【摘要】 目的:观察重型肝炎血清细胞因子在血浆置换、血液滤过等非生物型人工肝治疗前后的变化, 进一步探讨细胞因子和非生物型人工肝在重型肝炎发病机制及治疗中的意义。方法:设重型肝炎组和正常对照组,测定每组血清 IL-2、IL-6、TGF β₁、TNF-α、sFas、IFN-α的水平,以及重型肝炎组患者血清 IL-2、 IL-6、TGF β₁、TNF-α、sFas、IFN-α在非生物型人工肝治疗前后的水平,并比较它们的变化。结果:重型肝炎组患者治疗前血清 IL-2、IFN-α水平明显低于对照组,IL-6、TGF β₁、TNF-α、sFas 水平明显高于对照组;治疗后血清 IL-2、IFN-α水平较治疗前明显升高,IL-6、TGF β₁、TNF-α、sFas 水平较治疗前明显下降。死亡及疗效差自动出院的患者经人工肝治疗后血清细胞因子水平极易反弹,而治愈及好转的患者经人工肝治疗后血清细胞因子水平不易反弹。结论:非生物型人工肝对 IL-6、TGF β₁、TNF-α、sFas 有较好的清除作用,能使 IL-2、IFN-α水平升高,对重型肝炎有明显疗效。IL-2、IL-6、TGF β₁、TNF-α、sFas、 IFN-α的水平对评估重型肝炎的病情及预后有重要的临床意义。更多还原

【Abstract】 Objective:To observe change of hepatitis serum cytokine before and after treatment with non-bioartificial fiver such as plasmapheresis,hemofiltration et al,and further investigate the mechanism of cytokine and non-artificial fiver in severe hepatitis and significance in treatment.Methods:There were severe hepatitis group and normal control group,serum IL-2、IL-6、TGFβ1、TNF-α、sFas、IFN-αlevel of each group were detected,serum IL-2、IL-6、TGFβ1、TNF-α、sFas、IFN-αlevel of severe hepatitis patients before and after treatment with non-bioartificial fiver were detected,and investigated the comparison between them.ReSults: Serum IL-2、IFN-αlevel in severe hepatitis group before treatment were obviously lower than those of normal control group,but IL-6、TGFβ1、TNF-α、sFas level were obviously higher;Serum IL-2、IFN-αlevel in severe hepatitis group after treatment were obviously increased,but IL-6、TGFβ1、TNF-α、sFas level were obviously decreased.Serum cytokine of patients with death and bad curative effect after treatment with artificial liver were very easy to be increased again,Serum cytokine of patients with curing and improved patients after treatment with artificial fiver were not easy to be increased again.Conclusion:Non-bioartificial fiver has good cleaning effect on IL-6、TGFβ1、TNF-α、sFas,can make IL-2、IFN-α level increased,and has obvious curative effect.It has important clinical significance to assess pathogenetic condition and prognosis of severe hepatitis through detecting IL-2、IL-6、TGFβ1、TNF-α、sFas、IFN-αlevel.更多还原