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目的探讨肝硬化腹水患者体内前炎症细胞因子TNF-a、IL-6的水平及改变的原因。方法采用双抗体夹心酶联免疫吸附法(ELISA)检测94例肝炎肝硬化腹水患者腹水、血液标本中TNF-a、IL-6水平,同时应用鲎试剂三肽显色基质偶氮法检测标本内毒素水平,研究以上指标的相互关系及临床意义。结果①肝炎肝硬化自发性细菌性腹膜炎(SBP)组、无菌性腹水(SA)组血浆内毒素、TNF-a、IL-6浓度均显著高于健康对照组(P值均(0.001);②SBP组腹水内毒素、TNF-a、IL-6浓度均显著高于SA组(P值均(0.001);③肝硬化腹水患者血浆内毒素与TNF-a、IL-6水平正相关(P值均<0.001)。结论①肝炎肝硬化腹水患者存在细胞因子血症。②肝炎肝硬化腹水患者TNF-a,IL-6水平升高与体内内毒素水平升高有关。
Objective To investigate the levels of proinflammatory cytokines TNF-a and IL-6 in cirrhotic patients with ascites and their causes. Methods The levels of TNF-a and IL-6 in ascites and blood samples from 94 patients with liver cirrhosis and ascites were detected by double antibody sandwich enzyme-linked immunosorbent assay (ELISA). At the same time, Toxin levels, to study the relationship between the above indicators and clinical significance. Results ① The levels of plasma endotoxin, TNF-a and IL-6 in patients with hepatic cirrhosis spontaneous bacterial peritonitis (SBP) and aseptic ascites (SA) were significantly higher than those in healthy controls (P <0.001). ② The levels of endotoxin, TNF-a and IL-6 in SGP group were significantly higher than those in SA group (P <0.001). ③ The levels of plasma endotoxin in cirrhotic patients with ascites were positively correlated with TNF-a and IL-6 All <0.001) .Conclusion ① There are cytokinesmia in patients with liver cirrhosis and ascites.②The levels of TNF-a and IL-6 in cirrhotic patients with cirrhosis and cirrhosis are related to the increase of endotoxin in patients with cirrhosis.