婴儿巨细胞病毒肝炎治疗前后血清 IL-18及 TNF-α水平变化及其意义

摘要

目的分析婴儿巨细胞病毒（CMV）肝炎治疗前后血清白介素-18（IL-18）及肿瘤坏死因子-α（TNF-α）水平变化及意义。方法选取 CMV 肝炎婴儿120例，测定血清学、尿液及 B 超指标。分析血清 IL-18、TNF-α和肝功能指标的相关性。结果治疗有效组患儿治疗后的血清 IL-18、TNF-α较治疗无效组显著降低（P ＜0.05）。CMV 肝炎患儿治疗前血清 IL-18和 ALT、AKP 呈正相关（P ＜0.05），TNF-α和 ALT、AKP 呈正相关（P ＜0.05）。结论血清 IL-18、TNF-α水平对于 CMV 肝炎婴儿的肝功能损害程度具有一定的评价意义，同时可用于预测抗病毒疗效。%Objective To analyze the serum interleukin-18(IL-18)and tumor necrosis factor-α(TNF-α)levels and its signifi-cance before and after infant cytomegaloviru(CMV)hepatitis treatment. Methods A total of 120 cases of CMV hepatitis baby in our depart-ment were selected. The children in CMV group were divided into group with and without therapy. Serum,urine and B-ultrasound index were tested. The correlation was analyzed in CMV group before treatment in terms of serum IL-18,TNF-α and liver function. Results The serum IL-18,TNF-α,ALT,AKP,TBIL,γ-GT,the length of the right clavicle midline liver ribs,left clavicle midline ribs and spleen length CMV-DNA quantitative urine in group with therapy were significantly higher than those in the group without therapy(P < 0. 05). There was positive correlation between TNF-α and ALT,AKP,and between IL-18 and ALT,AKP(P < 0. 05). Conclusion In the diagnosis of infants with CMV hepatitis,the serum IL-18,TNF-α levels can be used in the evaluation of the extent of damage of liver function,and also in the predic-tion of the efficacy of anti-viral therapy.