【摘要】目的：探讨肝炎后肝硬化(posthepatitic cirrhosis，PHC)患者血清中细胞因子的水平变化及其与肝功能的关系。方法：采用ELISA法测定58例PHC患者和35例健康者血清细胞因子IL-6、IL-8、TNF-a的水平。同时将肝硬化患者按Child-Pugh肝功能分级标准分成A、B、C三组。结果：肝硬化组IL-6、IL-8、TNF-a的水平明显高于对照组，差异有统计学意义(P<0.01);Child-Pugh A、B、C三级的IL-6、IL-8、TNF-a水平依次递增，且各级间差异有统计学意义(P<0.01)。结论：随着IL-6、IL-8、TNF-a血清水平的升高而肝损伤程度加重，采用IL-6、IL-8、TNF-a作为临床判断肝脏损害程度的指标具有较好的临床参考价值。
【关键词】 肝硬化; 细胞因子; ELISA
Detection and Clinical Significance of the Cytokines in the Serum of Patients with Hepatic Cirrhosis
Abstract： Objective:To explore the serum levels of cytokines of patients with posthepatitil cirrhosis (HPC) and the relationship between the cytokines and liver function. Method：Using ELISA technique to measure the serum levels of IL-6、IL-8、TNF-a in 58 patients with posthepatitic cirrhosis(PHC) and 35 healthy peoples. The patients with posthepatitic cirrhosis(PHC) were classified by A、B、C groups according to the standard of child-pugh. Result：The serum levels of IL-6、IL-8 and TNF-α of patients with PHC were significantly higher than those in healthy control group (P<0.01). The serum levels of IL-6、IL-8 and TNF-α of Child-Pugh A、B、C groups were significantly higher than those in healthy groups. Conclusion：With the increase of the serum levels of IL-6、IL-8 and TNF-α, liver damage was aggravated, which indicated that there is an impediment in immune function and it is closely related to liver function. So it is of clinically value to adopt the serum levels of IL-6、IL-8 and TNF-α as an indicator to determine the degree to liver damage.
Key words： Hepatic cirrhosis; Cytokine; ELISA
近年来，大量的研究表明，肝硬化患者血清中细胞因子的含量升高，并且这些细胞因子水平的升高与肝硬化病情严重程度有关[1,2]。因此，本文测定58例乙型肝炎后肝硬化(posthepatitic cirrhosis，PHC)患者血清IL-6、IL-8、TNF-a的水平及血清总胆红素(TBiL)、谷草转氨酶(ALT)和白蛋白(ALB)的水平，并观察其与肝功能Child-pugh[3]分级关系，从而探讨IL-6、IL-8、TNF-a升高程度与肝功能损害程度的关系。
1 材料与方法
1.1 研究对象：PHC患者58例，均为我院住院及门诊患者，其中男性35例，女性23例，年龄35～65岁，平均50±3.3岁，均经CT肝穿刺病理证实为肝硬化，乙型肝炎病毒血清标志物二对半除HbsAb外至少二项阳
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