Clinical Significance And Detection Serum Level Of Endotoxin And STLR4in Patients With Hepatorenal Syndrome

Objective: To study serum of endotoxin、tumor necrosis factor-α（TNF-α）and soluble Toll-like receptor4（sTLR4）in liver cirrhosis withHeaptorenal syndrome and its clinical significance.Methods:50liver cirrhosis patients were divided into two Groups：single liver cirrhosis and liver cirrhosis with hepatorenal syndrome，15healthy subjects as controls. Their endotoxin and TNF-α、sTLR4weretested by linilus lysate test, enzyme-linked immunosorbent assay （ELISA）separately.spss17.0Correlation analysis was maken between endotoxin andTNF-α、 sTLR4respectively.Results:①50cases of patients with liver cirrhosis,among thetotal,nine patients were diagnosed with hepatorenal syndrome (HRS).②the level of endotoxin in liver cirrhosis group was significantly higherthan normal control group.With liver cirrhosis developed into HRS,endotoxin level was increased gradually,there was significantstatistic differ-ence between them（P<0.05）.The level of TNF-αin HRSgroup were significantly higher than single liver cirrhosis group andnormal control（P<0.05）.The level of TNF-α in normol controls、singleliver cirrhosis group、HRS group were21.43±9.11pg/ml、37.11±14.33pg/ml、62.19±14.06pg/ml respectively. With the development of livercirrhosis to HRS, sTLR4level decreased, but no significant differencebetween single liver cirrhosis group and HRS group（P＞0.05）.③Theendotoxin was positively correlated with TNF-αand correlationcoefficient was0.29.The correction analysis between endotoxin and sTLR4 was no significant statistic difference（P＞0.05）. TNF-α was negativelycorrelated with sTLR4and correlation coefficient was-0.41（P<0.05）.Conclusions：The serum levels of endotoxin、TNF-αin patients withhepatorenal syndrome were significantly higher than those of controls.Thelevels of sTLR4were decreased and negatively correlated with TNF-α.Endotoxin and TNF-α were involved in the development of livercirrhosis with hepatorenal syndrome.sTLR4maybe inhibit TNF-αproduction.