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目的 比较重型肝炎 (SH)并发自发性细菌性腹膜炎 (SBP)病人治疗前后心钠素 (ANP)、肿瘤坏死因子 (TNF α)含量变化。方法 用放射免疫法和免疫组化法对 90例SH合并SBP病人分别测定血浆中ANP、TNF α水平。结果 各型肝炎病人ANP和TNF α含量均明显高于正常对照组 (P <0 0 5 ) ;治疗后ANP和TNF α含量均低于治疗前 (P <0 0 5 ) ;SH合并SBP病人血浆及腹水中ANP和TNF α含量感染组均高于非感染组 (P <0 0 5 ) ,死亡组高于存活组 (P <0 0 5 ) ;并分别与血清胆红素 (SB)、凝血酶原时间 (PT)呈正相关 (r =0 5 7,r=0 6 4 ,P <0 0 1) ,与血清总胆固醇呈负相关 (r =0 5 8,P <0 0 1)。结论 SH并SBP病人检测ANP、TNF α含量的变化对临床的治疗有一定的价值。
Objective To compare the changes of ANP and TNFα in patients with severe hepatitis (SH) complicated with spontaneous bacterial peritonitis (SBP) before and after treatment. Methods Radioimmunoassay and immunohistochemistry were used to determine the levels of plasma ANP and TNFα in 90 SH patients with SBP. Results The levels of ANP and TNFα in patients with various types of hepatitis were significantly higher than those in normal controls (P <0.05), and the levels of ANP and TNFα in patients with various types of hepatitis were lower than those before treatment (P <0.05) (P <0.05), and those in the dead group were higher than those in the surviving group (P <0.05). The levels of serum bilirubin (SB), blood coagulation Serum total cholesterol was negatively correlated (r = 0 5 8, P 0 01). There was a positive correlation between enzyme and PT (r = 0 57, r = 0 64, P 0 01). Conclusion The changes of ANP and TNFα levels in patients with SH and SBP are of certain value in the clinical treatment.