Alterations of biliary biochemical constituents and cytokines in infantile hepatitis syndrome
Alterations of biliary biochemical constituents and cytokines in infantile hepatitis syndrome
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DOI：
10.3748/wjg.v12.i43.7038
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发表时间：
2006-11-21
影响因子：
4.3
通讯作者：
Zhang, Shu-Ling
中科院分区：
文献类型：
--
作者：
Ding, Yan;Zhao, Lei;Zhang, Shu-Ling
目的：探讨小儿肝炎综合征（IHS）患者胆道生化成分及细胞因子的变化。方法：检测42例IHS患者和21例对照组血清及胆汁生化成分，包括总胆红素（TBIL）、直接胆红素（DBIL）、丙氨酸转氨酶（ALT）、γ -谷氨酰转肽酶（γ - gt）、总胆汁酸（TBA）、白细胞介素-6 （IL-6）和肿瘤坏死因子- α (tnf - α)。IHS患者分为胆汁淤积组（n = 21）和肝炎组（n = 21）。结果：胆汁淤积组患者血清TBIL、DBIL、ALT、γ - gt、TBA、IL-6、TNF-a水平均高于对照组（P < 0.01）；胆道TBIL、DBIL、γ - gt、TBA水平均低于对照组，IL-6、tnf - α水平高于对照组（P < 0.01）。胆汁淤积组血清IL-6、tnf - α水平明显低于胆汁组（P < 0.01）。肝炎组患者血清DBIL、ALT、γ - gt、TBA、IL-6、tnf - α水平高于对照组（P < 0.01或140.57 +/- 70.32 vs 79.06 +/- 35.25, P < 0.05），胆道TBIL、DBIL、7-GT、TBA水平低于对照组（P < 0.01），胆道IL-6、tnf - γ水平高于对照组（P < 0.01）。肝炎组血清IL-6、tnf - α水平低于胆汁组（P < 0.01）。胆汁淤积组血清TBIL、DBIL、γ - gt、IL-6、tnf - α水平高于肝炎组，胆汁淤积组胆汁IL-6、tnf - α水平高于肝炎组。IHS患者胆道IL-6、tnf - α明显高于血清IL-6、tnf - α (P < 0.01)。IHS患者胆汁IL-6和tnf - α水平与血清DBIL、TBA和γ - gt水平呈正相关。结论：肝细胞损伤后胆道生化成分的改变与病理改变一致。胆汁淤积在胆汁淤积亚型的IHS患者中更为严重。胆道IL-6和tnf - α水平的测定可以特异性和敏感性地确定IHS中受损肝脏的炎症状态。(c) 2006年WJG出版社。版权所有。
AIM: To investigate the biliary biochemical constituents and cytokines in infantile hepatitis syndrome (IHS).METHODS: From 42 IHS subjects and 21 controls, serum and biliary biochemical constituents, including total bilirubin (TBIL), direct bilirubin (DBIL), alanine aminotransferase (ALT), gamma-glutamyl transpeptidase (gamma-GT), total bile acid (TBA), interleukin-6 (IL-6) and tumor necrosis factor-alpha (TNF-alpha) both in bile and serum, were assayed. The subjects with IHS were divided into a cholestasis group (n = 21) and a hepatitis group (n = 21).RESULTS: In the cholestasis group, serum TBIL, DBIL, ALT, gamma-GT, TBA, IL-6 and TNF-a levels were higher than those in the control (P < 0.01); and also the biliary TBIL, DBIL, gamma-GT and TBA levels were lower than those in the control, whereas biliary IL-6 and TNF-alpha levels were higher than those in the control (P < 0.01). In the cholestasis group, serum IL-6 and TNF-alpha levels were lower than those in bile (P < 0.01). In the hepatitis group, serum DBIL, ALT, gamma-GT, TBA, IL-6 and TNF-alpha levels were higher than those in the control (P < 0.01 or 140.57 +/- 70.32 vs 79.06 +/- 35.25, P < 0.05), while biliary TBIL, DBIL, 7-GT and TBA levels were lower than those in the control (P < 0.01), and biliary IL-6 and TNF-gamma levels were higher than those in the control (P < 0.01). In the hepatitis group, serum IL-6 and TNF-alpha levels were also lower than those in bile (P < 0.01). Serum TBIL, DBIL, gamma-GT, IL-6 and TNF-alpha levels in the cholestasis group were higher than those in the hepatitis group, while biliary IL-6 and TNF-alpha levels in the cholestasis group were higher than those in the hepatitis group. Biliary IL-6 and TNF-alpha were found to be more significantly increased than serum IL-6 and TNF-alpha in IHS (P < 0.01). The biliary IL-6 and TNF-alpha levels were positively correlated with serum DBIL, TBA and gamma-GT levels in IHS subjects.CONCLUSION: Biliary biochemical constituents alter in coincidence with pathological changes in hepatocellular injury. Cholestasis is more serious in IHS patients of cholestasis subtype. Assay of biliary IL-6 and TNF-alpha levels can be specific and sensitive to determine the inflammatory status of impaired liver in IHS. (c) 2006 The WJG Press. All rights reserved.