标题：梗阻性黄疸患者血清 sCD40L水平的变化及其临床意义

      作者：高伟芳 1，李晓 1，桑荣霞 1，李宁 1，刘铭 1，韩占波 1，万玲玲 2    (石家庄市第一医院消化二科 1、检验科 2，河北 石家庄 050011)

      卷次： 2017年28卷8期

      【摘要】 目的 观察梗阻性黄疸(OJ)患者血清可溶性CD40配体(sCD40L)水平的变化，并探讨其临床意义。方法 选择2015年4~12月在我院消化二科住院治疗的OJ患者35例作为观察组，另选同期在我院进行健康检查的志愿者35例作为对照组，检测对照组在入院时及观察组治疗前、治疗后3 d的血清谷丙转氨酶(ALT)、谷草转氨酶(AST)、总胆红素(TBIL)、结合胆红素(DBIL)、血清 sCD40L、肿瘤坏死因子-α (TNF-α)和白细胞介素-8 (IL-8)的水平，分析OJ患者的 sCD40L与其他指标的相关性。结果 观察组患者治疗前的血清ALT、AST、TBIL、DBIL、sCD40L、TNF-α和IL-8水平分别为(55.34±10.35) IU/L、(62.19±11.25) IU/L、(35.43±5.22) μmol/L、(8.94±2.58) μmol/L、(3.25±0.27) μg/L、(58.24±10.38) ng/L、(60.23±10.37) ng/L，均高于对照组的(32.17±5.32) IU/L、（36.27±6.78) IU/L、(10.19±4.58) μmol/L、(4.39±1.37) μmol/L、(2.84±0.32) μg/L、(34.52±9.26) ng/L、(43.69±11.26) ng/L，差异均有统计学意义 (P<0.05)，且观察组治疗后上述指标分别为（43.27±9.89）IU/L、(47.25±10.14) IU/L、(13.32±4.19) μmol/L、(6.18±2.97) μmol/L、(2.92±0.25) μg/L、(42.37±8.79) ng/L、(50.14±11.32) ng/L，均明显低于治疗前，差异均有统计学意义(P<0.05)。OJ患者的血清 sCD40L与血清TNF-α、IL-8、ALT、AST、TBIL及DBIL之间均呈正相关(均P<0.05)。结论 OJ患者血清 sCD40L水平明显上升，且其与炎症反应及肝功能指标联系紧密，临床可通过监测血清 sCD40L变化了解患者病情，评估预后。
      【关键词】 血清 sCD40L；梗阻性黄疸；肝损伤；预后
      【中图分类号】 R575 【文献标识码】 A 【文章编号】 1003—6350（2017）08—1280—03

Change of serum sCD40L in patients with obstructive jaundice and its significance.
GAO Wei-fang 1, LI Xiao 1,SANG Rong-xia 1, LI Ning 1, LIU Ming 1, HAN Zhan-bo 1, WAN Ling-ling 2. Second Department of Gastroenterology 1,Department of Clinical Laboratory 2, Shijiazhuang First Hospital, Shijiazhuang 050011, Hebei, CHINA
【Abstract】 Objective To observe the change of the serum soluble CD40 ligand (sCD40L) in patients with ob-structive jaundice (OJ), and explore its significance. Methods From April to December in 2015, 35 OJ patients whowere treated in Second Department of Gastroenterology in our hospital were selected as the observation group, andmeanwhile 35 healthy volunteers were enrolled as the control group. The levels of serum alanine aminotransferase(ALT), aspartate aminotransferase (AST), total bilirubin (TBIL), conjugated bilirubin (DBIL), and serum sCD40L, tumornecrosis factor-α (TNF-α) and interleukin-8 (IL-8) at admission in control group and before and 3 d after treatment inthe observation group were detected. Then the correlations between sCD40L and above indexes in OJ patients were ana-lyzed. Results The levels of serum ALT, AST, TBIL, DBIL, sCD40L, TNF-α and IL-8 were (55.34 ± 10.35) IU/L,(62.19±11.25) IU/L, (35.43±5.22) μmol/L, (8.94±2.58) μmol/L, (3.25±0.27) μg/L, (58.24±10.38) ng/L, (60.23±10.37) ng/Lin observation group before treatment, respectively, which were significantly higher than (32.17±5.32) IU/L, (36.27±6.78) IU/L, (10.19±4.58) μmol/L, (4.39±1.37) μmol/L, (2.84±0.32) μg/L, (34.52±9.26) ng/L, (43.69±11.26) ng/L in controlgroup (P<0.05). The above indexes were (43.27±9.89) IU/L, (47.25±10.14) IU/L, (13.32±4.19) μmol/L, (6.18±2.97) μmol/L,(2.92±0.25) μg/L, (42.37±8.79) ng/L, (50.14±11.32) ng/L in observation group after treatment respectively, which weresignificantly lower than before treatment (P<0.05). Serum sCD40L was positively correlated with serum TNF-α, IL-8,·论 著·doi:10.3969/j.issn.1003-6350.2017.08.026基金项目：2014年度河北省石家庄市科学技术研究与发展指导计划项目（编号：141463143）