乙型肝炎肝硬化合并肝性脑病患者血清LPSTNF―α和IL―6表达变化及意义.docVIP

乙型肝炎肝硬化合并肝性脑病患者血清LPS、TNF―α和IL―6的表达变化及意义 　　[摘要] 目的 ?z测乙型肝炎肝硬化合并肝性脑病（hepatic encephalopathy，HE）患者血清中内毒素（LPS）、肿瘤坏死因子-α（TNF-α）和白细胞介素（IL）-6水平，探讨其表达变化及意义。 方法 选择2014年8月～2016年8月在嘉兴市第一医院住院的患者90例，将68例乙肝肝硬化合并肝性脑病的患者设为A组，其中25例临床分级0级为A1组，25例1～2级为A2组，18例3～4级为A3组，22例乙肝肝硬化患者为B组，20例健康体检者为正常对照组（C组）。检测研究对象血清中LPS、TNF-α和IL-6水平，并分析其与TBil、ALT、AST、ALB、血氨的相关性。结果 A组患者血氨浓度较B组、C组升高，差异有统计学意义（P0.05）。 结论 LPS、TNF-α和IL-6是HE发生发展中重要的炎症介质，参与HE的免疫调节过程，分析其水平及变化可能有助于HE的病情判断及预后评估。 　　[关键词] 肝性脑病；肿瘤坏死因子-α；白细胞介素-6；内毒素 　　[中图分类号] R277 [文献标识码] A [文章编号] 1673-9701（2017）10-0012-04 　　Changes of expression of serum LPS， TNF-α and IL-6 in patients with hepatitis B-related cirrhosis complicated with hepatic encephalopathy and its significance 　　WANG Keyin1 WU Yiming1 LU Xuzhen1 ZOU Zhuolin1 LU Mingqin2 　　1.Department of Infection， Jiaxing First Hospital in Zhejiang Province， Jiaxing 314000， China； 2.Department of Infection， the First Affiliated Hospital of Wenzhou Medical University， Wenzhou 325000， China 　　[Abstract] Objective To investigate the levels of LPS， tumor necrosis factor-α （TNF-α） and interleukin （IL）-6 in the serum of the patients with hepatitis B-related cirrhosis complicated with hepatic encephalopathy（HE）， and to explore its expression changes and significance. Methods A total of 90 patients who were admitted to Jiaxing First Hospital from August 2014 to August 2016 were selected. 68 patients with hepatitis B-related liver cirrhosis complicated with hepatic encephalopathy were selected as group A. Among them， 25 patients with clinical grading of 0 were assigned to group A1， 25 patients with grading of 1 to 2 were assigned to group A2， and 18 patients with grading of 3 to 4 were assigned to group A3. 22 patients with hepatitis B-related liver cirrhosis were assigned to group B， and 20 healthy subjects were assigned to the normal control group， as group C. The levels of LPS， TNF-α and IL-6 in the serum of research subjects were measured， and their correlations with TBil， ALT， AST， ALB and blood am