Zeni F, Tardy B, Vindimian M, Comtet C, Page Y, Cusey I, Bertrand J C
Emergency Care unit and the Nuclear Medicine Laboratory, Hôpital Bellevue, Etienne, France.
Clin Infect Dis. 1993 Aug;17(2):218-23. doi: 10.1093/clinids/17.2.218.
We prospectively measured the concentrations of immunoreactive tumor necrosis factor-alpha (TNF-alpha), interleukin-1 (IL-1), and interleukin-6 (IL-6) in the serum and ascitic fluid of 14 alcoholic cirrhotic patients with spontaneous bacterial peritonitis (SBP) and 16 alcoholic cirrhotic patients with sterile ascitic fluid. TNF-alpha levels in ascitic fluid were significantly higher for the patients with SBP: 399.57 +/- 129.23 pg/mL vs. 35.76 +/- 5.57 pg/mL (P < .001). IL-6 levels in ascitic fluid were also significantly higher for the patients with SBP: 170,713 +/- 57,109 ng/mL vs. 5,414 +/- 973 ng/mL (P < .001). By contrast, serum levels of TNF-alpha and IL-6 were just slightly more elevated than normal values. The concentration of IL-1 in the ascitic fluid of all patients was elevated, but there was no difference between patients with SBP or sterile ascites in this respect. In the patients with SBP, levels of TNF-alpha and IL-6 in ascitic fluid decreased during the first 48 hours of antibiotic treatment. Our results suggest that measurements of TNF-alpha and IL-6 in ascitic fluid may become useful markers both for the diagnosis of SBP and for monitoring the treatment of cirrhotic patients.
我们前瞻性地检测了14例患有自发性细菌性腹膜炎（SBP）的酒精性肝硬化患者以及16例无菌性腹水的酒精性肝硬化患者血清和腹水中免疫反应性肿瘤坏死因子-α（TNF-α）、白细胞介素-1（IL-1）和白细胞介素-6（IL-6）的浓度。SBP患者腹水中的TNF-α水平显著更高：399.57±129.23 pg/mL对比35.76±5.57 pg/mL（P<.001）。SBP患者腹水中的IL-6水平也显著更高：170,713±57,109 ng/mL对比5,414±973 ng/mL（P<.001）。相比之下，血清中的TNF-α和IL-6水平仅略高于正常值。所有患者腹水中的IL-1浓度均升高，但在这方面SBP患者与无菌性腹水患者之间并无差异。在SBP患者中，抗生素治疗的头48小时内腹水中的TNF-α和IL-6水平下降。我们的结果表明，检测腹水中的TNF-α和IL-6可能成为诊断SBP以及监测肝硬化患者治疗的有用标志物。
