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目的 阐明可溶性CD14 (sCD14 )在慢性乙型肝炎 (慢乙肝 )肠源性内毒素血症中的作用。方法 ELISA双抗体夹心法测定了 6 0例慢乙肝患者血清sCD14和TNF α水平 ,应用基质显色法鲎试验定量检测血浆内毒素水平。结果 慢乙肝 (轻度 )患者血清sCD14水平与对照组无显著差异外 ,慢乙肝 (中度和重度 )sCD14水平均显著高于对照组 ;慢乙肝伴肠源性内毒素血症时sCD14s为 (4.8± 2 .3) μg/ml,而不伴肠源性内毒素血症者的sCD14为 (2 .9± 1.9) μg/ml,两者之间有显著差异 (P <0 .0 1)。慢乙肝 (轻度 )sCD14水平为 (3 .0± 1.7) μg/ml ,TNF α为 (4.6 9± 2 .75 )ng/ml,两者之间无显著相关 (r =0 .2 6 ,P >0 .0 5 ) ,而慢乙肝 (中度和重度 )的sCD14水平分别为 (5 .2± 2 .1) μg/ml和 (6 .9±3 .4) μg/ml,TNF α分别为 (9.48± 6 .15 )ng/ml和 (14 .2 3± 8.2 9)ng/ml ,慢乙肝 (中度和重度 )的sCD14水平分别与其TNF α有显著相关 (r =0 .87,P <0 .0 1;r =0 .91,P <0 .0 1)。结论 血清中sCD14水平影响并调节内毒素对肝细胞的毒性 ,临床测定肝病患者sCD14水平 ,有助于阐明慢性肝病时肠源性内毒素血症在继发性肝损害中的作用。
Objective To elucidate the role of soluble CD14 (sCD14) in the intestinal endotoxemia of chronic hepatitis B (chronic hepatitis B). Methods Serum levels of sCD14 and TNFα in 60 patients with chronic hepatitis B were measured by sandwich enzyme-linked immunosorbent assay (ELISA). Quantitative detection of plasma endotoxin levels was performed by matrix colorimetry. Results The serum levels of sCD14 in patients with chronic hepatitis B (mild) were not significantly different from those in controls. The levels of sCD14 in patients with chronic hepatitis B (moderate and severe) were significantly higher than those in controls. The sCD14s in patients with chronic hepatitis B and endogenous endotoxemia were ( 4.8 ± 2.3μg / ml), while those with no endogenous endotoxemia (sCD14) were (2.9 ± 1.9) μg / ml, with significant difference (P <0.01) . The level of sCD14 in chronic hepatitis B (mild) was (3.0 ± 1.7) μg / ml and that of TNFα was (4.6 9 ± 2.75) ng / ml, with no significant correlation between them (r = P> 0.05), while the sCD14 levels in chronic hepatitis B (moderate and severe) were (5.2 ± 2.1 μg / ml and (6.9 ± 3.4) μg / ml, (9.48 ± 6.15) ng / ml and (14.22 ± 8.29) ng / ml, respectively. The levels of sCD14 in chronic hepatitis B (moderate and severe) were significantly correlated with their TNFα (r = 0.87 , P <0. 01; r = 0 .91, P <0. 01). Conclusion Serum levels of sCD14 affect and regulate the toxicity of endotoxin to hepatocytes. To determine the level of sCD14 in patients with hepatopathy is helpful to clarify the role of intestinal endotoxemia in secondary liver injury in patients with chronic liver disease.