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目的：研究肿瘤坏死因子α（ＴＮＦ－α）在慢性肝病中的作用和意义．方法：采用放射免疫分析法测定２０例慢性迁延性肝炎（ＣＰＨ），２０例慢性活动性肝炎（ＣＡＨ）和５１例肝炎后肝硬变（ＬＣ）患者血清中ＴＮＦ－α的含量．结果：ＣＡＨ和ＬＣ患者血清ＴＮＦ－α含量（１．１１±０．５９μｇ／Ｌ，０．９２±０．６６μｇ／Ｌ）显著高于正常对照组［０．５６±０．０８μｇ／Ｌ（Ｐ＜０．０１，Ｐ＜０．０５）］．肝病中ＴＮＦ－α的含量与其胆红质（ＢＩＬ）和谷丙转氨酶（ＡＬＴ）的含量呈正相关（ｒ＝０．９７９１，Ｐ＜０．０５）．ＬＣ组中，按Ｃｈｉｌｄ肝功分级标准，Ａ，Ｂ，Ｃ各组血清ＴＮＦ－α含量依次递增，且各组间有显著差异（Ｐ＜０．０１）．ＬＣ合并感染者血清ＴＮＦ－α含量（１．８８±０．８７μｇ／Ｌ）显著高于未合并感染者［０．８９±０．４３μｇ／Ｌ（Ｐ＜０．０１）］，且易发生肝－肾综合征（Ｐ＜０．０５）．结论：ＴＮＦ－α可能参与慢性肝病肝细胞损害过程，其含量越高，肝功能损害就越重．同时，血清中高浓度的ＴＮＦ－α可能是ＬＣ患者发生合并症的原因之一．
Objective: To study the role and significance of tumor necrosis factor-α (TNF-α) in chronic liver disease. Methods: Serum levels of TNF-α in 20 patients with chronic persistent hepatitis (CPH), 20 patients with chronic active hepatitis (CAH) and 51 patients with posthepatitic cirrhosis (LC) were determined by radioimmunoassay. Results: The levels of TNF-α in serum of CAH and LC patients (1.11 ± 0.59μg / L, 0.92 ± 0.66μg / L) were significantly higher than those of the normal control group [0.56 ± 0.08μg / L <0.01, P <0.05)]. The level of TNF-α in liver disease was positively correlated with the levels of bilirubin and ALT (r = 0.9791, P <0.05). LC group, according to Child’s liver function grading standards, serum TNF-αlevels in groups A, B and C increased in sequence with significant difference (P <0.01). The level of TNF-α in serum of LC co-infected patients (1.88 ± 0.87μg / L) was significantly higher than that of non-co-infected patients (0.89 ± 0.43μg / L, P <0.01) - Renal syndrome (P <0.05). Conclusion: TNF-α may be involved in the process of liver cell damage in chronic liver disease. The higher the content of TNF-α, the more severe liver damage. In the meantime, the high concentration of serum TNF-α may be one of the causes of complications in LC patients.