Sheron N, Bird G, Koskinas J, Portmann B, Ceska M, Lindley I, Williams R
Institute of Liver Studies, King's College School of Medicine and Dentistry, London, UK.
Hepatology. 1993 Jul;18(1):41-6.
Acute alcoholic hepatitis is characterized by a unique degree of liver neutrophil infiltration, often accompanied by marked peripheral neutrophilia in the absence of demonstrable bacterial or fungal infection. In this study we assayed plasma and tissue levels of a potent neutrophil activator and chemotaxin, interleukin-8, in patients with a spectrum of alcoholic liver diseases and in normal and diseased control subjects. Levels of circulating interleukin-8 were undetectable in normal subjects but highly elevated in patients with alcoholic hepatitis, particularly in those who died (geometric mean = 600 ng/L; confidence interval = 323 to 1,120 vs. geometric mean = 184 ng/L; confidence interval = 114 to 309 in survivors). Levels correlated with biochemical indicators of severe disease (bilirubin: R = 0.38; international prothrombin ratio: R = 0.28; white blood cell count: R = 0.35; creatinine: R = 0.34) and with tumor necrosis factor-alpha (R = 0.43) and soluble tumor necrosis factor receptors (p55; R = 0.59). In contrast, moderate elevations in the levels of circulating interleukin-8 were seen in alcoholic cirrhosis (geometric mean = 93 ng/L; confidence interval = 40 to 213) and in alcoholic patients undergoing alcohol withdrawal (geometric mean = 137 ng/L; confidence interval = 72 to 259). Levels in nonalcoholic inflammatory liver disease were comparatively low (geometric mean = 17 ng/L; confidence interval = 10 to 29).(ABSTRACT TRUNCATED AT 250 WORDS)
急性酒精性肝炎的特征是肝脏有独特程度的中性粒细胞浸润,通常在无明显细菌或真菌感染的情况下伴有显著的外周血中性粒细胞增多。在本研究中,我们检测了一系列酒精性肝病患者以及正常和患病对照受试者血浆和组织中一种强效中性粒细胞激活剂和趋化因子白细胞介素-8的水平。正常受试者循环白细胞介素-8水平检测不到,但酒精性肝炎患者中该水平显著升高,尤其是那些死亡患者(几何平均数 = 600 ng/L;置信区间 = 323至1120,而存活患者几何平均数 = 184 ng/L;置信区间 = 114至309)。该水平与严重疾病的生化指标相关(胆红素:R = 0.38;国际凝血酶原比值:R = 0.28;白细胞计数:R = 0.35;肌酐:R = 0.34),并与肿瘤坏死因子-α(R = 0.43)和可溶性肿瘤坏死因子受体(p55;R = 0.59)相关。相比之下,酒精性肝硬化患者(几何平均数 = 93 ng/L;置信区间 = 40至213)和戒酒的酒精性患者(几何平均数 = 137 ng/L;置信区间 = 72至259)循环白细胞介素-8水平有中度升高。非酒精性炎症性肝病患者的该水平相对较低(几何平均数 = 17 ng/L;置信区间 = 10至29)。(摘要截短于250字)