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目的探讨慢性肝病患者血清瘦素、肿瘤坏死因子(TNFα)水平的变化及其临床意义。方法用放射免疫法检测91例慢性肝病(慢性迁延性肝炎25例,慢性活动性肝炎28例,肝炎后肝硬化38例)患者血清瘦素、TNFα水平。结果慢性肝病患者血清瘦素、TNFα水平明显高于正常对照组,且随病情发展逐渐增高(P<0.01)。慢性肝病患者的血清瘦素、TNFα水平与层粘蛋白(LN)、透明质酸(HA)、Ⅲ型前胶原(PCⅢ)、Ⅳ胶原(CⅣ)、总胆红素(TBiL)呈正相关(P<0.01),与凝血酶原活动度(PTA)、白、球蛋白比例(A/G)呈显著负相关(P<0.01)。结论瘦素与TNFα可能与肝细胞损害和肝脏炎症活动程度密切相关。
Objective To investigate the changes of serum leptin and tumor necrosis factor (TNF) in patients with chronic liver disease and its clinical significance. Methods The levels of serum leptin and TNFα in 91 cases of chronic liver disease (25 cases of chronic persistent hepatitis, 28 cases of chronic active hepatitis and 38 cases of posthepatitis cirrhosis) were detected by radioimmunoassay. Results The levels of serum leptin and TNFα in patients with chronic liver disease were significantly higher than those in normal controls (P <0.01). The levels of serum leptin and TNFα in patients with chronic liver disease were positively correlated with LN, HA, PCⅢ, CⅣ, TBiL (P <0.01). There was a significant negative correlation between activity of prothrombin (PTA), white and globulin (A / G) (P <0.01). Conclusion Leptin and TNFα may be closely related to the damage of hepatocytes and the degree of liver inflammation.