目的探讨重型肝炎患者血清皮质醇水平与预后的关系,为临床判断预后及探讨治疗提供理论依据。方法对临床诊断的重型肝炎患者进行血清皮质醇、TNFα含量检测;比较重型肝炎、急性肝炎和慢性肝炎患者血清皮质醇水平的差异以及重型肝炎患者中死亡组和存活组的差异;检测血清皮质醇含量与TNFα含量的相关性。结果重型肝炎患者血清皮质醇水平明显低于急、慢性肝炎患者,尤以死亡组患者更为明显;血清皮质醇水平与TNFα含量呈显著负相关。结论重型肝炎患者存在肾上腺皮质功能不全,且与患者预后密切相关。 Objective To investigate the relationship between serum cortisol level and prognosis in patients with severe hepatitis and provide a theoretical basis for clinical judgment and treatment. Methods The levels of serum cortisol and TNFα in patients with severe hepatitis were detected. The differences of serum cortisol levels among patients with severe hepatitis, acute hepatitis and chronic hepatitis and between death group and survival group were compared. Serum cortisol Correlation between content and TNFα content. Results The levels of serum cortisol in patients with severe hepatitis were significantly lower than those in patients with acute and chronic hepatitis, especially those in death group. Serum cortisol level was negatively correlated with TNFα level. Conclusions There is adrenocortical insufficiency in patients with severe hepatitis, which is closely related to the prognosis of patients.