Min W Q, Gu C H, Wang Y M
Department of Infectious Diseases, Southwest Hospital, Third Military Medical College, Chongqing.
Zhonghua Yi Xue Za Zhi. 1994 Oct;74(10):602-4, 645-6.
Plasma soluble tumor necrosis factor receptor (sTNFR) was detected by radioimmunoprecipitation-polyethylene glycol assay in 64 patients with viral hepatitis B. The levels of two distinct receptors (sTN-FR1 and sTNFR2) were significantly higher in chronic severe hepatitis (CSH) followed by chronic active hepatitis (CAH), chronic persistent hepatitis (CPH), and acute hepatitis (AH) or controls (P < 0.01). A more markedly increased sTNFR was observed in patients with high SB (> 342 mumol/L), low Pa (< 20%), and secondary infection or fatal outcome. For patients with 20% below of sTNFR levels, the increase of TNF was proportional to that of sTNFR. But, for patients with exceeding 20% of sTNFR, the ratio of TNF/sTNFR became higher. The ratio of TNF to sTNFR may be greatly indicative to determine the clinical severity and outcome. Administration of sTNFR could prevent the adverse pathologic sequence caused by the exaggerated TNF and open a new therapeutical field.
采用放射免疫沉淀-聚乙二醇法检测了64例乙型病毒性肝炎患者血浆可溶性肿瘤坏死因子受体（sTNFR）。两种不同受体（sTN-FR1和sTNFR2）的水平在慢性重型肝炎（CSH）中显著升高，其次是慢性活动性肝炎（CAH）、慢性持续性肝炎（CPH）、急性肝炎（AH）或对照组（P<0.01）。在血清胆红素（SB）>342μmol/L、动脉血氧分压（Pa）<20%、有继发感染或预后不良的患者中观察到sTNFR更明显升高。对于sTNFR水平低于20%的患者，肿瘤坏死因子（TNF）的升高与sTNFR的升高成比例。但是，对于sTNFR超过20%的患者，TNF/sTNFR比值升高。TNF与sTNFR的比值可能对判断临床严重程度和预后有很大指示作用。给予sTNFR可预防由过度的TNF引起的不良病理过程，开辟一个新的治疗领域。
