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1、·22·ChinJDisControlPrev2004Feb;8(1)血清TNF2A及h2EGF含量与重型病毒性肝炎的预后周和龙,何生松,曾令兰,李淑莉,杨小铭,罗端德【摘要】 目的 为探讨重症肝炎预后的影响因素,本文检测了49例重肝患者血清TNF2A和h2EGF含量变化。方法 采用ABC2ELISA方法分别测定血清TNF2A和h2EGF含量。结果 死亡组患者血清TNF2A水平治疗前稍高于存活组,且与对照组比较差异有显著性,而h2EGF却相反。随着病情进展,死亡组TNF2A水平升高,h2EGF水平降低;存活组与
2、之相反。血清TNF2A水平越高,病死率越高;而h2EGF水平越高,病死率越低。结论 TNF2A及h2EGF分别能反映肝细胞坏死及再生情况,其动态检测能较好预测重肝发展趋势,可用作评判重肝预后的指标。【关键词】 肿瘤坏死因子ö诊断应用;表皮生长因子2尿抑肾素ö诊断应用;肝炎,病毒性,人ö康复【中图分类号】R512.604 【文献标识码】A 【文章编号】100826013(2004)0120022203TherelationshipofserumTNF-Aandh-EGFlevelsandprognosisof
3、severeviralhepatitisZHOUHe2long,HESheng2song,ZENGLing2lan,LIShu2li,YANGXiao2ming,LUODuan2de.UnionHospitalofTongjiMedicalCollege,HuazhongUniverityofScienceandTechnology,Wuhan430022,China【Abstract】 ObjectiveTostudytheinfluencingfactorstheprognosisofseverehepat
4、itis,wede2terminedtheserumlevelsofTNF2Aandhumanepidermalgrowthfactor(h2EGF)in49patientswithseverehepatitis.MethodsABC2ELISAwasusedfortestingtheserumlevelsofTNF2A,h2EGFrespectively.ResultsSerumTNF2Alevelsofdeathgroupbeforetherapywerelightlyhigherthatofsurviva
5、lgroup,Pvalueofwere<0.01whilecomparingwithcontrolgroup,butthelevelofh2EGFwasjustopposite.ASliverdiseaseprogressedgradually,serumTNF2Alevelsofdeathgroupincreasedwhileh2EGFleveldecreased.Butthoseofsurvivalgroupwereopposite.ThehigherlevelserumTNF2Awere,thehighe
6、rmortalitieswere;butthehigherlevelserumh2EGFwere,thelowermortalitieswere.ConclusionsSerumTNF2Aandh2EGFcanindicatethedegreeofhepaticnecrosisandregenerationrespectively.Thedynamicdeterminationofthemmightpre2dictfairlythetrendofseverehepatitisprognosis,andwereu
7、sedasindicesofevaluatingseverehepatitisprognosis.【Keywords】 tumornecrosisfactorödiagnosticuse;epidernalgrowthfactor2urogastroneödiagnos2ticuse;hepatitis,viral,humanörehabilitation(ChinJDisControlPrev2004,8(1):22224) 肝细胞大量坏死是重肝的发病基础,是影响重合成均有明显刺激或抑制作用,为探讨判断重肝
8、预肝预后的重要因素。目前临床上常采用PT及总胆后的指标,本文联合检测重肝患者血清TNF2A及红素等指标来判断肝坏死的严重性,但由于受出血,h2EGF含量变化,以期对临床诊治有指导意义。DIC等多种因素影响,它们并不能反映有效肝功能1 材料与方法储备水平。许多报道证实,TNF2A不仅可直接或间接引起肝细胞坏死或凋亡,而且还是其它肝毒性物1.1 研究对象 49例重肝患者均系同济医学院附1,
