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目的:研究肝硬化并发自发性腹膜炎(SBP)患者血清及腹水中瘦素水平的变化和临床意义,并探讨其与TNF-α、IL-6的关系。方法:采用放射免疫法测定67例肝硬化腹水患者(SBP组32例,漏出液组35例)血清及腹水瘦素水平,同时采用双抗体夹心ELISA法测定血清及腹水的TNF-α、IL-6水平。结果:SBP组血清及腹水瘦素、TNF-α、IL-6水平明显高于漏出液组(P<0.01),且腹水的瘦素、TNF-α、IL-6水平又高于血清(P<0.01和P<0.05);感染控制后,血清和腹水瘦素、TNF-α、IL-6水平明显降低(P<0.01和P<0.05);SBP治疗无效组的初始血清和腹水瘦素、TNF-α、IL-6水平明显高于治疗有效组(P<0.01和P<0.05);肝硬化患者血清和腹水的瘦素与TNF-α、IL-6变化呈正相关。结论:肝硬化并发SBP时血清和腹水中的瘦素、TNF-α、IL-6明显升高,临床上检测血清和腹水的瘦素、TNF-α、IL-6水平对SBP的早期诊断、疗效判断及预后评估均有意义。
Objective: To study the changes and clinical significance of leptin levels in serum and ascites of patients with cirrhosis complicated with spontaneous peritonitis (SBP), and to explore its relationship with TNF-α, IL-6. Methods: Serum and ascites levels were measured in 67 patients with ascites due to cirrhosis (32 in SBP group and 35 in leakage group) by radioimmunoassay. Serum and ascites levels of TNF-α and IL- 6 levels. Results: The levels of leptin, TNF-α and IL-6 in serum and ascites in SBP group were significantly higher than those in leakage group (P <0.01), and the levels of leptin, TNF-α and IL- <0.01 and P <0.05). After infection control, serum and ascites leptin, TNF-α and IL-6 levels were significantly lower (P <0.01 and P <0.05); initial serum and ascites leptin levels in SBP- The levels of TNF-α and IL-6 in serum and ascites in patients with cirrhosis were significantly higher than those in the treatment group (P <0.01 and P <0.05). Conclusions: Serum and ascitic fluid levels of leptin, TNF-α and IL-6 in cirrhotic patients with SBP are significantly increased. Serum and ascitic fluid levels of leptin, TNF-α and IL-6 are positively correlated with the early diagnosis of SBP. Judgment of efficacy and prognosis evaluation are meaningful.