目的 探讨慢性丙型肝炎(慢丙肝)患者血清肿瘤坏死因子-α(TNF-α)水平与病变程度、病毒学指标、抗病毒治疗应答效果之间的相关性.方法 102例慢丙肝和30例健康对照检测血清TNF-α水平,慢丙肝按肝功实验室检查异常程度分为轻度44例、中度34例、重度24例,慢丙肝进行血肝功能检测、HCV RNA载量、HCV基因型的检测.结果 血清TNF-α水平慢丙肝患者高于健康对照;肝功能异常轻度者低于中度和重度;与CHE呈正相关;与DBIL呈负相关;与HCV RNA载量无相关性;在不同HCV基因型感染者间差异无统计学意义;与干扰素-α治疗疗效无关.结论 慢丙肝患者血清TNF-α水平高于健康对照组,并与病变程度相关,与干扰素-α治疗疗效无关.%Objective To assess the relationship between the level of serum TNF-α of chronic hepatitis C with severity of disease and curative effect of anti-virus therapy with interferon α. Methods Thirty healthy controls and 102 patients with chronic hepatitis C were recruited into this study. The level of serum TNF-α was determined by ELISA in both groups. Then the 102 patients with chronic hepatitis C were evaluated after being classified into mild (44 eases), moderate (34 cases), and severe types (24 cases) based on the results of liver function tests. Liver functions, viral load and genotype of HCV RNA were measured. Results Before anti-virus treatment, the level of fasting serum TNF-α in the patients with chronic hepatitis C (1) was higher than that of the normal controls; (2) in the cases with mild type was lower than that in the moderate and severe groups; (3) serum TNF-α was not associated with the HCV load; (4) serum TNF-α was not significantly different between HCV subtypes lb and 2a; (5) serum TNF-α was not significantly different between the patients responsive and non-responsive to the anti-vires treatment; (6) serum TNF-α was positively correlated with the level of serum direct bilirubin, negatively correlated with cholinesterase (CHE). Conclusions The level of fasting serum TNF-α in the patients with chronic hepatitis was higher than that in the normal controls, and was positively correlated with the severity of the disease but not correlated with the therapeutic effect of interferon-α.
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