Nagaki M, Iwai H, Naiki T, Ohnishi H, Muto Y, Moriwaki H
First Department of Internal Medicine, Gifu University School of Medicine, Gifu, Japan.
J Infect Dis. 2000 Oct;182(4):1103-8. doi: 10.1086/315826. Epub 2000 Aug 28.
Serum pro- and anti-inflammatory mediators in patients with acute liver diseases were assessed to clarify the clinical significance of these measurements in relation to disease severity. Concentrations of circulating tumor necrosis factor (TNF)-alpha, interleukin (IL)-1beta, IL-6, IL-10, IL-12, and soluble TNF receptors (sTNFR) p55 and p75 were measured at admission in patients with fulminant hepatitis (FH; n=19), severe acute hepatitis (AHS, n=15), or acute hepatitis (AH, n=7). Serum concentrations of TNF-alpha, IL-10, and sTNFR-55 were significantly higher in patients with FH than in those with AHS (P<.05, <.05, and <.01, respectively) or AH (P<.05). Serum IL-10 and TNF-alpha levels were higher in patients who died of FH (n=13) than in FH survivors (n=6; P<.05). The ratios between TNF-alpha and IL-10 and sTNFR-55 or sTNFR-75 were not valuable in predicting mortality and disease severity. However, both proinflammatory cytokine TNF-alpha and anti-inflammatory cytokine IL-10 levels at admission were associated with fatal outcome among patients with FH.
对急性肝病患者的血清促炎和抗炎介质进行评估，以阐明这些检测指标与疾病严重程度相关的临床意义。在暴发性肝炎（FH；n = 19）、重度急性肝炎（AHS，n = 15）或急性肝炎（AH，n = 7）患者入院时，检测循环肿瘤坏死因子（TNF）-α、白细胞介素（IL）-1β、IL-6、IL-10、IL-12以及可溶性TNF受体（sTNFR）p55和p75的浓度。FH患者的血清TNF-α、IL-10和sTNFR-55浓度显著高于AHS患者（分别为P <.05、<.05和<.01）或AH患者（P <.05）。死于FH的患者（n = 13）的血清IL-10和TNF-α水平高于FH幸存者（n = 6；P <.05）。TNF-α与IL-10以及sTNFR-55或sTNFR-75之间的比值在预测死亡率和疾病严重程度方面并无价值。然而，入院时促炎细胞因子TNF-α和抗炎细胞因子IL-10的水平均与FH患者的致命结局相关。
