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目的 探讨慢性乙型肝炎（慢乙肝）患者血清中sCD14的水平与继发肠源性内毒素血症的关系。方法 以ELISA法检测60例慢乙肝患者血清sCD14和TNF-(水平，同时，应用基质显色法定量检测了患者血浆内毒素水平并将三者与对照组进行比较。结果 轻度慢乙肝（A组）患者血清sCD14水平与对照组无显著差异（P>0.05），中度慢乙肝（B组）和重度慢乙肝（C组）sCD14水平均显著高于对照组（P<0.01）；慢乙肝继发肠源性内毒素血症者血清中sCD14s为（4.8±2.3）(g/ml，而无继发肠源性内毒素血症者其sCD14为（2.9±1.9）(g/ml，两者之间有显著差异 ( P<0.01)。A组患者血清中sCD14水平为（3.0±1.7）(g/ml，而TNF-(为（4.69±2.75）ng/ml，两者之间无显著相关性（γ= 0.76，P>0.05）；而B组和C组其sCD14水平分别为（5.2±2.1）(g/ml和（6.9±3.4）(g/ml，TNF-(分别为（9.48±6.15）ng/ml和（14.23±8.29）ng/ml，B组、C组的sCD14水平分别与自身组TNF-(有显著相关性（γ=0.87，P<0.01；γ=0.91，P<0.01）。结论 慢乙肝继发肠源性内毒素血症者sCD14水平显著升高，说明sCD14水平可显著提高慢乙肝患者对内毒素的敏感性，LPS与sCD14结合，诱导单核-巨噬细胞产生TNF-(，从而损伤肝细胞。
Objective To investigate the relationship between serum sCD14 level and secondary enterogenous endotoxemia in patients with chronic hepatitis B (chronic hepatitis B). Methods Serum levels of sCD14 and TNF-α in 60 patients with chronic hepatitis B were measured by ELISA. Plasma endotoxin levels in patients with chronic hepatitis B were detected quantitatively by matrix colorimetry and compared with that of the control group.Results Mild chronic hepatitis B (A SCD14 levels in patients with moderate chronic hepatitis B (B group) and severe chronic hepatitis B (C group) were significantly higher than those in control group (P <0.01); chronic hepatitis B Serum levels of sCD14s in secondary intestinal endotoxemia were (4.8 ± 2.3) g / ml without secondary enterogenous endotoxemia, with sCD14 of 2.9 ± 1.9 (g / ml, two (P <0.01) .The serum levels of sCD14 in group A were (3.0 ± 1.7) g / ml and (4.69 ± 2.75) ng / ml, respectively, with no significant difference between the two groups (5.2 ± 2.1) g / ml and (6.9 ± 3.4) g / ml and TNF- (9.48, respectively) in group B and group C (γ = 0.76, P> 0.05) ± 6.15) ng / ml and (14.23 ± 8.29) ng / ml, respectively. There was a significant correlation between sCD14 levels in group B and group C and their own group TNF- (r = 0.87, 0.01) .Conclusion Chronic hepatitis B secondary The level of sCD14 in endotoxemia was significantly increased, indicating that sCD14 levels can significantly increase the sensitivity of endotoxin in chronic hepatitis B patients. The combination of LPS and sCD14 induces monocyte-macrophage to produce TNF- (thus damaging hepatocytes .