Odeh M, Sabo E, Srugo I, Oliven A
Department of Internal Medicine B, Bnai Zion Medical Center, Technion Faculty of Medicine, Israel Institute of Technology, Haifa, Israel.
Liver Int. 2004 Apr;24(2):110-6. doi: 10.1111/j.1478-3231.2004.0894.x.
Several studies have shown that serum levels of tumor necrosis factor-alpha (TNF) are significantly elevated in patients with acute and chronic liver diseases, where these elevations are independent of the etiology of the underlying disease. Serum levels of TNF are significantly higher in patients with cirrhosis than in those without cirrhosis, reaching the highest levels in decompensated cirrhosis. It has also been shown that plasma levels of TNF correlate with the severity of hepatic encephalopathy (HE) in fulminant hepatic failure. However, still there are no published data regarding the relationship between blood levels of TNF and the presence or severity of HE in patients with chronic liver failure.
The aim of this study is to determine the relationship between serum levels of TNF and clinical grades of HE in patients with liver cirrhosis.
Using a commercially available high-sensitivity enzyme-linked immunosorbent assay kit, serum levels of TNF were measured in 74 patients with liver cirrhosis in various clinical grades of HE (grades 0-4).
The mean+/-SEM values of serum levels of TNF at presentation in patients with grade 0 of HE (n=23), grade 1 (n=12), grade 2 (n=14), grade 3 (n=16), and grade 4 (n=9) were 4.50+/-0.46, 9.10+/-1.0, 12.98+/-1.22, 21.51+/-2.63, and 58.26+/-19.7 pg/ml, respectively. A significant positive correlation was found between serum levels of TNF and the severity of HE (P<0.0001).
Serum levels of TNF correlate positively with the severity of HE in patients with chronic liver failure.
多项研究表明，急性和慢性肝病患者血清肿瘤坏死因子-α（TNF）水平显著升高，且这些升高与潜在疾病的病因无关。肝硬化患者的血清TNF水平显著高于无肝硬化者，在失代偿期肝硬化患者中达到最高水平。也有研究表明，暴发性肝衰竭患者血浆TNF水平与肝性脑病（HE）的严重程度相关。然而，关于慢性肝衰竭患者血液中TNF水平与HE的存在或严重程度之间的关系，仍无公开数据。
本研究旨在确定肝硬化患者血清TNF水平与HE临床分级之间的关系。
使用市售的高灵敏度酶联免疫吸附测定试剂盒，对74例处于不同HE临床分级（0 - 4级）的肝硬化患者测定血清TNF水平。
HE 0级（n = 23）、1级（n = 12）、2级（n = 14）、3级（n = 16）和4级（n = 9）患者就诊时血清TNF水平的平均值±标准误分别为4.50±0.46、9.10±1.0、12.98±1.22、21.51±2.63和58.26±19.7 pg/ml。发现血清TNF水平与HE严重程度之间存在显著正相关（P < 0.0001）。
慢性肝衰竭患者血清TNF水平与HE严重程度呈正相关。
