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目的 探讨慢性丙型肝炎 (HCV)患者血清肿瘤坏死因子 (TNF)和可溶性肿瘤坏死因子受体 (s TNF-R)的变化及其临床意义。方法 应用酶联免疫吸附试验 (EL ISA)检测慢性 HCV患者血清 TNF和 s TNF- R水平 ;同时采用速率法在全自动生化分析仪上测定血清丙氨酸转氨酶 (AL T)和天冬氨酸转氨酶 (AST)活性。结果 慢性 HCV患者血清 TNF和 s TNF- R显著高于正常人 (P<0 .0 1) ;血清 s TNF- R2与 AST、 AL T显著相关 (r=0 .75 ,P<0 .0 1;r=0 .6 9、P<0 .0 1) ;而 s TNF- R1仅与 AST相关 (r=0 .6 6 ,P<0 .0 1) ;慢性 HCV患者 s TNF- R1/ TNF、s TNF- R2 / TNF摩尔比分别为 33.5± 18.4、 85 .1± 37与 s TNF- R1和 s TNF- R2显著相关 (r=0 .71,P<0 .0 1;r=0 .6 2 ,P<0 .0 1) ;而s TNF- R和 TNF无显著相关 (P>0 .0 5 )。结论 慢性 HCV患者血清 TNF/ s TNF- R水平升高反映机体强烈的免疫反应 ,与肝细胞损伤密切有关
Objective To investigate the changes of serum tumor necrosis factor (TNF) and soluble tumor necrosis factor receptor (s TNF-R) in patients with chronic hepatitis C (HCV) and their clinical significance. Methods Serum levels of TNF and TNF-α in patients with chronic HCV were detected by enzyme-linked immunosorbent assay (ELISA). Serum alanine aminotransferase (ALT) and aspartate Aminotransferase (AST) activity. Results Serum levels of TNF and TNF-α in patients with chronic HCV were significantly higher than those in normal controls (P <0.01). Serum TNF-R2 levels were significantly correlated with AST and ALT (r = 0.75, P <0.01 ; r = 0.96, P <0.01); while s TNF-R1 was only associated with AST (r = 0.66, P <0.01) , S TNF-R2 / TNF molar ratio were 33.5 ± 18.4, 85.1 ± 37 and s TNF-R1 and s TNF-R2 significantly correlated (r = 0.71, P <0.01; 6 2, P <0. 01). There was no significant correlation between s TNF-R and TNF (P> 0.05). Conclusions The elevated serum TNF / s TNF-R level in chronic HCV patients reflects the strong immune response in the body and is closely related to hepatocellular injury