肝硬化患者的血浆白细胞介素-6水平。与内毒素血症、肿瘤坏死因子-α及高动力循环的关系。

Plasma interleukin-6 levels in patients with cirrhosis. Relationship to endotoxemia, tumor necrosis factor-alpha, and hyperdynamic circulation.

作者信息

Lee F Y, Lu R H, Tsai Y T, Lin H C, Hou M C, Li C P, Liao T M, Lin L F, Wang S S, Lee S D

机构信息

Dept. of Medicine, Veterans General Hospital-Tapei, Taiwan.

出版信息

Scand J Gastroenterol. 1996 May;31(5):500-5. doi: 10.3109/00365529609006772.

DOI:10.3109/00365529609006772

PMID:8734349

Abstract

BACKGROUND

Liver cirrhosis with portal hypertension is associated with hyperdynamic circulation characterized by generalized vasodilatation and increased cardiac output and regional blood flows. Patients with liver cirrhosis present with increased levels of interleukin-6 (IL-6), which may inhibit vascular smooth-muscle contraction. We investigated whether increased plasma IL-6 levels contribute to the pathogenesis of hyperdynamic circulation observed in cirrhotic patients and whether they are correlated with plasma tumor necrosis factor-alpha (TNF-alpha) and endotoxin concentrations.

METHODS

In 58 consecutive cirrhotic patients and 34 healthy subjects the plasma concentrations of TNF-alpha and IL-6 were measured with enzyme-linked immunosorbent assay, and endotoxin determinations with a limulus assay. In addition, 52 cirrhotic patients underwent a hemodynamic study using Swan-Ganz catheterization.

RESULTS

Plasma TNF-alpha, IL-6, and endotoxin levels were significantly higher in cirrhotic patients than in healthy subjects (7.3 +/- 0.2 versus 5.8 +/- 0.1 pg/ml, 6.4 +/ 0.8 versus 2.0 +/- 0.2 pg/ml, and 7.6 +/- 1.2 versus 2.8 +/- 0.3 pg/ml, respectively; p < 0.01). In cirrhotic patients the plasma levels of TNF-alpha IL-6, and endotoxin progressively increased in relation to the severity of liver dysfunction (graded by Pugh's classification). A significant correlation was observed between plasma TNF-alpha and IL-6 levels (r = 0.48, p < 0.001), whereas no correlation was observed between plasma endotoxin levels and plasma TNF-alpha and IL-6 levels. Plasma IL-6 levels correlated negatively with systemic vascular resistance in patients with cirrhosis (r = 0.5, p < 0.01).

CONCLUSIONS

Plasma IL-6 levels are increased in patients with cirrhosis. The severity of liver cirrhosis is an important factor for the occurrence of increased IL-6 levels. IL-6 may play a role in the hyperdynamic circulation observed in patients with cirrhosis.

摘要

背景

肝硬化伴门静脉高压与高动力循环相关，其特征为全身血管扩张、心输出量增加及局部血流增加。肝硬化患者白细胞介素-6（IL-6）水平升高，这可能抑制血管平滑肌收缩。我们研究了血浆IL-6水平升高是否有助于肝硬化患者高动力循环的发病机制，以及它们是否与血浆肿瘤坏死因子-α（TNF-α）和内毒素浓度相关。

方法

对58例连续的肝硬化患者和34例健康受试者，采用酶联免疫吸附测定法测量血浆TNF-α和IL-6浓度，用鲎试剂测定法测定内毒素。此外，52例肝硬化患者使用Swan-Ganz导管进行了血流动力学研究。

结果

肝硬化患者的血浆TNF-α、IL-6和内毒素水平显著高于健康受试者（分别为7.3±0.2对5.8±0.1 pg/ml、6.4±0.8对2.0±0.2 pg/ml、7.6±1.2对2.8±0.3 pg/ml；p<0.01）。在肝硬化患者中，血浆TNF-α、IL-6和内毒素水平随肝功能障碍的严重程度（根据Pugh分类法分级）而逐渐升高。血浆TNF-α和IL-6水平之间观察到显著相关性（r=0.48，p<0.001），而血浆内毒素水平与血浆TNF-α和IL-6水平之间未观察到相关性。肝硬化患者血浆IL-6水平与全身血管阻力呈负相关（r=0.5，p<0.01）。