【摘要】 目的:探讨肝炎后肝硬化患者血清和腹水中白细胞介素(IL)-8、肿瘤坏死因子(TNF)-α的变化及其在疾病发生、发展中的作用。方法:应用双单克隆抗体夹心法酶联免疫吸附测定(ELISA)和放射免疫测定(RIA)检测36例肝炎后肝硬化患者血清和腹水中IL-8、TNF-α的含量及动态活性变化。结果:肝硬化合并自发性细菌性腹膜炎(SBP)患者的血清和腹水中IL-8、TNF-α水平明显高于未合并SBP者及对照组,未合并SBP者亦明显高于对照组(P<0.05~0.01)。合并SBP者经抗感染治疗后两参数水平均显著下降,治疗后1周开始下降,4周后与未合并SBP者水平相当。合并SBP者发生肾功能损害时,血清和腹水中的IL-8、TNF-α水平明显高于未发生肾功能损害者。结论:检测血清和腹水中的IL-8、TNF-α水平有助于判定肝炎后肝硬化合并SBP经抗感染治疗后的疗效;腹水感染程度可以用腹水中IL-8、TNF-α的水平来反映;高水平IL-8、TNF-α在肝炎后肝硬化合并SBP者发生肾功能损害中可能起一定作用。更多还原

【Abstract】 Aims: To investigate the dynamic changes of interleukin (IL)-8 and tumor necrosis factor (TNF)-α in serum and ascitic fluid of patients with posthepatitic cirrhosis, and to explore the role of IL-8 and TNF-α in the development and progression of hepatic cirrhosis. Methods: Dynamic changes of the serum and ascitic fluid levels of IL-8 and TNF-α in 36 patients with cirrhosis were detected by double-monoclonal-antibody enzyme-linked immunosorbent assay (ELISA) and radioimmunoassay (RIA). Results: The serum and ascitic fluid levels of IL-8 and TNF-α in cirrhotic patients complicated by spontaneous bacterial peritonitis (SBP) were significantly higher than those in the control group and higher than those in cirrhotic patients without SBP. In the control group, the serum and ascitic fluid levels of IL-8 and TNF-α were less than those in the cirrhotic patients without SBP (P<0.05-0.01), these levels gradually decreased in cirrhotics complicated with SBP after antibacterial treatment for 7 days and normalized in 4 weeks. The serum and ascitic fluid levels of IL-8 and TNF-α were significantly increased when complicated with SBP and impairment of renal function. Conclusions: It is useful to test the serum and ascitic fluid levels of IL-8 and TNF-α, particularly after the antibacterial therapy in cirrhotic patients complicated with SBP. The ascitic fluid levels of IL-8 and TNF-α can reflect the degree of infection in the ascites. Higher levels of IL-8 and TNF-α in cirrhotic patients with SBP may possibly play a role in the pathogenesis of renal function impairment.更多还原