Felver M E, Mezey E, McGuire M, Mitchell M C, Herlong H F, Veech G A, Veech R L
Laboratory of Metabolism and Molecular Biology, National Institute on Alcohol Abuse and Alcoholism, Rockville, Maryland 20852.
Alcohol Clin Exp Res. 1990 Apr;14(2):255-9. doi: 10.1111/j.1530-0277.1990.tb00482.x.
Plasma tumor necrosis factor alpha (TNF alpha), interleukin 1 alpha (IL-1 alpha), and interleukin 1 beta (IL-1 beta) were measured in plasma samples obtained from 23 patients with severe alcoholic hepatitis on admission and after 30 days of hospitalization. Over a 2-year follow-up period, 14 patients died at a mean time of 8 months following discharge. The presence of elevated plasma TNF alpha either at admission or discharge from the hospital was associated with death in 82% (14/17) of patients. By contrast absence of elevated plasma TNF alpha was associated with survival in 100% (6/6). The difference in survival with and without detectable plasma TNF alpha was significant at p = 0.0022. Plasma TNF alpha was not elevated in alcoholic patients without clinically apparent liver disease, with alcoholic cirrhosis, or in nonalcoholic healthy controls. Plasma IL-1 alpha was also significantly increased in alcoholic hepatitis whereas IL-1 beta was not. Neither IL-1 alpha nor beta was correlated with outcome in the alcoholic hepatitis group. It is concluded that the presence of elevated plasma TNF alpha is a significant predictor of decreased long-term survival in patients with severe alcoholic hepatitis.
对23例重症酒精性肝炎患者入院时及住院30天后采集的血浆样本，检测了血浆肿瘤坏死因子α（TNFα）、白细胞介素1α（IL-1α）和白细胞介素1β（IL-1β）。在2年的随访期内，14例患者在出院后平均8个月时死亡。入院时或出院时血浆TNFα升高的患者中，82%（14/17）死亡。相比之下，血浆TNFα未升高的患者100%存活（6/6）。血浆TNFα可检测与不可检测患者的生存率差异具有显著性（p = 0.0022）。无明显临床肝病的酒精性患者、酒精性肝硬化患者或非酒精性健康对照者的血浆TNFα未升高。酒精性肝炎患者的血浆IL-1α也显著升高，而IL-1β未升高。酒精性肝炎组中，IL-1α和IL-1β均与预后无关。结论是，血浆TNFα升高是重症酒精性肝炎患者长期生存率降低的重要预测指标。
