非酒精性脂肪性肝病患者外周血Ghrelin、脂联素与炎性细胞因子检测的临床意义

目的：探讨非酒精性脂肪性肝病（NAFLD）患者外周血Ghrelin、脂联素及炎性细胞因子表达水平与NAFLD发生及肝脏损害程度的关系及临床意义。方法：NAFLD组50例（单纯性脂肪肝患者30例，脂肪性肝炎患者20例）、脂肪肝并发糖耐量减低（IGT）组10例、脂肪肝并发血脂异常组20例均为本科住院患者，另选取本院体检中心体检者20例作为健康对照组。采用酶联免疫吸附实验（ELISA）检测各组血浆中Ghrelin、脂联素、胰岛素及TNF-α水平，并进行相关性分析。结果：NAFLD组患者外周血Ghrelin及脂联素表达均低于对照组（P<0.01），TNF-α表达高于对照组（P<0.01）；脂联素与TNF-α、体质量指数(BMI)和胰岛素抵抗指数(HOMA-IR)呈负相关(r=－0.811，P<0.01；r=－0.678，P<0.01；r=－0.727，P<0.01)，与Ghrelin呈正相关（r=0.836，P<0.01）。结论： Ghrelin、脂联素和炎性细胞因子等在胰岛素敏感性和炎症方面有拮抗作用，这些细胞因子系统的失衡是NAFLD发病及病情进展的关键因素。

Clinical significances of detection of Ghrelin,adiponectin and inflammatory cytokines in peripheral blood of patients with NAFLD

Objective To explore the relationships between the expressions of Ghrelin,adiponectin,TNF-α in the peripheral blood of the patients with non-alcoholic fatty liver disease(NAFLD)and occurrence and development of NEFLD and clinical significances.Methods 50 patients with NAFLD(including 30 cases of simple fatty liver and 20 cases of fatty hepatitis),10 patients with fatty liver and impaired glucose tolerance(IGT),20 cases of fatty liver and dyslipidemia were selected,and 20 healthy subjects were used as control group.The expressions of Ghrelin,adiponectin,insulin and TNF-α in the peripheral blood of the patients and healthy subjects were detected with ELASI.Results The expressions of Ghrelin and adiponectin in all experimental groups were significantly lower than those in control group(P<0.01);The expression of TNF-α in all experimental groups were higher than that in control group(P<0.01);adiponectin was negatively correlated with TNF-α,BMI and HOMA-IR(r=-0.811,P<0.01;r=-0.678.P<0.01;r=-0.727.P<0.01),but positively correlated with Ghrelin(r= 0.836,P<0.01).Conclusion Ghrelin and adiponectin play important roles in the occurrence and development of NAFLD.