Murch S H, Lamkin V A, Savage M O, Walker-Smith J A, MacDonald T T
Department of Paediatric Gastroenterology, St Bartholomew's Hospital, West Smithfield, London.
Gut. 1991 Aug;32(8):913-7. doi: 10.1136/gut.32.8.913.
Serum tumour necrosis factor alpha (TNF alpha) concentrations were measured by enzyme linked immunoadsorbent assay in 31 normal children and during 65 episodes of clinical remission and 54 episodes of relapse in 92 children with chronic inflammatory bowel disease. An appreciable rise in TNF alpha was found only in children in relapse of ulcerative colitis and colonic Crohn's disease. The group of children with small bowel Crohn's disease in relapse did not show increases of TNF alpha above control concentrations, despite an equivalent rise in disease indices. Height velocity was depressed in children with relapse of large bowel Crohn's disease and ulcerative colitis compared with the equivalent condition in remission. The impairment of growth velocity was significantly greater in relapse of large bowel Crohn's disease and ulcerative colitis than in small bowel Crohn's disease alone, although for the subgroups in stage 1 puberty (prepubertal) the differences were not significant. Inadequate growth in chronic inflammatory bowel disease is currently ascribed to inadequate nutrition and TNF alpha may contribute to this through its cachexia inducing effects. It may, in addition, diminish pituitary growth hormone release. These results suggest that production of TNF alpha may be associated with growth failure in relapse of colonic inflammatory bowel disease.
采用酶联免疫吸附测定法，对31名正常儿童以及92名患有慢性炎症性肠病的儿童在65次临床缓解期和54次复发期的血清肿瘤坏死因子α（TNFα）浓度进行了测量。仅在溃疡性结肠炎和结肠克罗恩病复发的儿童中发现TNFα有明显升高。小肠克罗恩病复发组的儿童，尽管疾病指标有同等程度的升高，但TNFα浓度并未高于对照浓度。与处于缓解期的同等情况相比，大肠克罗恩病和溃疡性结肠炎复发的儿童身高增长速度下降。大肠克罗恩病和溃疡性结肠炎复发时生长速度的受损程度明显大于仅小肠克罗恩病，不过对于1期青春期（青春期前）的亚组而言，差异并不显著。目前认为慢性炎症性肠病患儿生长不足与营养不足有关，而TNFα可能因其诱导恶病质的作用对此有影响。此外，它可能会减少垂体生长激素的释放。这些结果表明，TNFα的产生可能与结肠炎症性肠病复发时的生长衰竭有关。
