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目的探讨肿瘤坏死因子α（ＴＮＦα）与肝纤维化的关系．方法采用放射免疫分析法测定慢性轻型肝炎（ＭＣＨ）２０例，慢性重型肝炎（ＳＣＨ）２０例，肝硬变（ＬＣ）５１例患者及正常人３２例血清ＴＮＦα，层粘连蛋白（ＬＮ）和透明质酸（ＨＡ）含量，分析它们的变化规律．同时对其中３２例（正常人７例，ＭＣＨ３例，ＳＣＨ５例和ＬＣ１７例）肝组织中ＴＮＦα和Ⅲ型胶原用免疫组织化学方法检测并用ＶＧ染色观察总胶原含量．结果ＳＣＨ和ＬＣ患者血清ＴＮＦα，ＬＮ和ＨＡ含量均明显高于对照组（ＳＣＨ：１１１±０５９，１３０７±１７２，２１９１±１２１３；ＬＣ：０９２±０６６，１５６８±３１７，４００５±１８３７，Ｐ＜００５～００１）．在ＭＣＨ、ＳＣＨ和ＬＣ的ＬＮ和ＨＡ含量逐渐升高，并呈显著正相关（ｎ＝９１，γ＝０３１４９；Ｐ＜００１）．ＭＣＨ和ＳＣＨ患者，血清ＴＮＦα与其ＬＮ，ＨＡ含量呈正相关（ＬＮ：ｎ＝４０，γ＝０３４０４，Ｐ＜００５；ＨＡ：ｎ＝４０，γ＝０３８４７；Ｐ＜００５）．ＭＣＨ，ＳＣＨ和ＬＣ肝组织中Ⅲ型胶原及总胶原含量逐渐增加．ＳＣＨ，ＬＣ肝组织中ＴＮＦα阳性细胞数均明显高于对照组?
Objective To investigate the relationship between tumor necrosis factor α (TNFα) and hepatic fibrosis. Methods Twenty patients with chronic mild hepatitis (MCH), 20 with chronic severe hepatitis (SCH), 51 with cirrhosis (LC) and 32 with normal serum were measured by radioimmunoassay. Serum TNFα, laminin (LN) And hyaluronic acid (HA) content, analysis of their changes. At the same time, 32 cases of normal (7 cases of normal, MCH3 cases, SCH5 cases and LC17 cases) TNF α and Ⅲ type collagen detected by immunohistochemistry and VG staining to observe the total collagen content. Results The contents of TNF-α, LN and HA in SCH and LC patients were significantly higher than those in control group (SCH: 111 ± 059,1307 ± 172,2191 ± 1213; LC: 0 92 ± 066,1568 ± 317,4005 ± 1837, P <005 ~ 001). At MCH, the content of LN and HA in SCH and LC increased gradually and positively correlated (n = 91, γ = 03149; P <001). MCH and SCH patients, serum TNF α and LN, HA content was positively correlated (LN: n = 40, γ = 0 3404, P <0 05; HA: n = 40, γ = 0 3847; 05). MCH, SCH and LC liver tissue type Ⅲ collagen and collagen content gradually increased. SCH, LC liver tissue TNF @ positive cells were significantly higher than the control group?