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目的 探讨TNF α在肝炎发病中的作用及重症肝炎患者血清内毒素水平与TNF α活性水平之间的关系。方法 选择不同临床类型的肝炎患者 84人 ,正常对照组 18人 ,比较各型患者血清TNF α活性 ,并就血清内毒素水平与TNF α活性水平之间的关系进行了研究。结果 TNF α活性水平在各组间总的差别有显著性 (F =2 1.53,P <0 .0 1) ,呈现出重症肝炎 >CH(重 ) >CH(中 ) >CH(轻 ) >肝硬化 >AH ;且重症肝炎组明显高于其他各组 (P均 <0 .0 1) ,其它各组间差别无显著性。慢性乙肝 (重度 )合并G- 杆菌感染者和TNF α活性与内毒素水平呈正相关 (r =0 .9111,P >0 .0 5)。结论 TNF α可能参与了重症肝炎的发生 ,内毒素通过刺激单核巨噬细胞产生大量TNF α促进肝细胞的坏死。
Objective To investigate the role of TNFα in the pathogenesis of hepatitis and the relationship between serum endotoxin levels and TNFα activity in patients with severe hepatitis. Methods Eighty-four patients with different clinical types of hepatitis and 18 normal controls were enrolled in this study. The serum levels of TNFα were compared between the two groups. The relationship between serum endotoxin levels and TNFα activity was also studied. Results There was a significant difference in the levels of TNFα between the groups (F = 2 1.53, P <0.01), with severe hepatitis> CH> CH> CH> Sclerosis> AH; and severe hepatitis group was significantly higher than other groups (P <0.01), the other groups no significant difference. Chronic hepatitis B (severe) with G-cell infection and TNFα activity and endotoxin levels were positively correlated (r = 0.91 1, P> 0.05). Conclusion TNF α may be involved in the development of severe hepatitis. Endotoxin promotes the necrosis of hepatocytes by stimulating monocyte-derived macrophages to produce large amounts of TNFα.