Objective:To explore the changes and diagnostic value of CD14, CD64, and IL-6 in secondary liver failure. Method:30 patients with secondary liver infection who were hospitalized in our hospital from July 2016 to July 2017 were selected as the infection group.30 patients with hepatic failure treated in our hospital during the same period were selected as uninfected groups. 10 cases of physical examinations in our hospital during the same period for health monitoring were selected as the control group. Patients with confirmed liver failure secondary to ascites infection were treated with drugs; ascites and fasting peripheral venous blood were collected. The levels of CD14 and CD64 in patients were measured using a FACSCalibur flow cytometer produced by BD, USA; IL-6 in serum was measured by an electrochemiluminescence immunoassay(ELISA). Results:The levels of CD14, CD64, and IL-6 in the blood of infected patients(before treatment) were(46.32±8.41) mg·L-1,(12 942.21±328.18) mol/cell,(2 148.13±894.35) pg·dl-1,significantly higher than those of the uninfected group (0.62±0.20) mg·L-1,(1 028.45±139.41) mol/cell,(84.42±56.26) pg·dl-1, and the control group (0.52±0.11) mg·L-1,(983.95±126.27) mol/cell,(13.52±12.71) pg·dl-1, The levels of CD14, CD64, and IL-6 in the ascitic fluid of the infected group(before treatment) were (61.24±6.41) mg·L-1,(14 815.06±362.21) mol/cell, and(9 720.82±7 910.25) pg·dl-1, respectively. In the uninfected group (1.92±1.20) mg·L-1,(836.13±103.22) mol/cell,(1 648.31±1 321.45) pg·dl-1, the difference was statistically significant (P<0.05).The levels of CD14, CD64, and IL-6 in the peripheral blood of the infected patients were (46.32±8.41) mg·L-1,(12 942.21±328.18) mol/cell, and (2 148.13±894.35) pg·dl-1, respectively. Lowere than those in the ascites, CD14, CD64, IL-6 content (61.24±6.41) mg·L-1,(14 815.06±362.21) mol/cell,(9 720.82±7 910.25) pg/dl, the difference between the data was statistically significant (P<0.05). Conclusion:CD 14, CD64 and IL-6 have some reference value in the diagnosis of liver failure caused by infection, and the sensitivity of ascites examination is better than that of serum. |
[1] HELBLING D,BUCHAKLIAN A,WANG J.et al.Reduced mitochondrial DNA content and heterozygous nuclear gene mutations in patients with acute liver failure[J].J Pediatr Gastroenterol Nutr,2013,57(4):438-443.
[2] WLODZIMIROW K A,ESLAMI S,ABU-HANNA A,et al. A systematic review on prognostic indicators of acute on chronic liver failure and their predictive value for mortality[J].Liver Int,2013,33(1):40-52.
[3] 韩秀国,马宽生,夏锋,等.肝硬化肝癌和无肝硬化肝癌患者围术期肝衰竭和死亡的相关因素分析[J].中华消化外科杂志,2016,15(6):605-614.
[4] LIU C T,CHEN T H,CHENG C Y,et al.Successful treatment of drug-induced acute liver failure with high-volume plasma exchange[J].J Clin Apher,2013,28(6):430-434.
[5] 杨方集,彭亮,刘月英,等.2016年肝衰竭诊治进展[J].中华肝脏病杂志,2017,25(2):94-99.
[6] 安彬彬,饶素玉,樊淑玉,等.肝衰竭患者人工肝置留管感染的病原学分布特征与相关细胞因子水平变化分析[J].浙江临床医学,2017,19(10):1901-1903.
[7] 陈妍雯,胡世芸,潘宗琴,等.我国肝衰竭真菌感染危险因素荟萃分析[J].中华医院感染学杂志,2014,24(10):2493-2496.
[8] 王传敏,孟忠吉,陈悦,等.血清降钙素原检测对肝衰竭合并感染的早期诊断价值[J].临床肝胆病杂志,2017,33(6):1137-1140.
[9] 乔艳,吕飒,李晨,等.酒精性肝衰竭患者临床特征分析[J].肝脏,2016,21(12):1023-1026.
[10] 谢能文,涂慧敏,何金秋,等.江西省南昌地区急性肝衰竭病因及临床特点分析[J].中国现代医学杂志,2017,27(1):120-124.
[11] 朱冰,刘婉姝,游绍莉,等.不明原因肝衰竭的研究进展[J].临床肝胆病杂志,2015,31(9):1509-1512.
[12] 吴宗盛,张峰,史东阳,等.肝衰竭患者呼吸机相关性肺炎病原学特征及预后分析[J].中华肝脏病杂志,2016,24(12):930-932.
[13] 徐慧,邓意志.乙型肝炎表面抗原(HBsAg)阳性与HBsAg阴性甲型肝炎患者的临床特征比较[J].中国现代医学杂志,2014,24(25):61-65.
[14] 张国栋.肝衰竭患者血清降钙素原测定的应用价值[J].中国医药,2015,10(8):1154-1156.
[15] 李小鹏,王亮,饶希,等.降钙素原、C-反应蛋白检测在肝衰竭合并腹腔感染中的临床价值[J].南昌大学学报:医学版,2017,57(5):33-35. |