الفهرس 
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Abstract
Cirrhosis is a gradually developing, chronic disease of the liver which always involves the organ as a whole. It is the irreversible consequence and final stage of various chronic liver diseases of different etiology. The extent of the morphological changes depends on the cause and stage of cirrhosis.
Hepatic encephalopathy (HE) is a potentially serious disturbance in central nervous system function that can result from hepatic insufficiency.
Studies indicate that mediators of inflammation (tumor necrosis factor-alpha (TNF-a), interleukin-I beta (IL-IB), interleukin-6 (IL-6)) may exacerbate the effects of ammonia on the brain.
IL-6 is a pleiotropic cytokine with a wide range of biological activities in immune regulation, hematopoiesis, inflammation and oncogenesis. Its activities are shared by IL-6 related cytokines such as leukemia inhibitory factor (LIF), cilliary neurotrophic factor (CNTF) and oncostatin.
It is well known that the onset of SIRS during acute liver failure or chronic liver failure heralds a poor prognosis. Brain signaling potentially occurs via one of several mechanisms: the direct transfer of cytokines by way of active transport, interactions with receptors on circumventricular organs lacking the blood-brain barrier, or the activation of afferent neurons of the vagus nerve. It has been suggested that systemic inflammatory signals have the potential to result in increased permeability of the blood brain barrier to cytokines in those with liver disease.
It was found that Median arterial ammonia, tumour necrosis factor-alpha, Interleukin-6, Interleukin-16 and serum endotoxin levels were significantly higher in patient with hepatic encephalopathy and minimal hepatic encephalopathy as compared to patients without minimal hepatic encephalopathy and healthy controls.
We investigated the relationship between serum IL-6 and other demographic, clinical and laboratory data to identify the role of IL-6 in hepatic encephalopathy in patients with liver cirrhosis.
Serum IL-6 of encephalopathy group was significantly higher than cirrhotic group.
There was a significant increase serum IL-6 level with the advancement of the grade of hepatic encephalopathy .
MELD score, Child-Pugh score, APRI score and FIB-4 score were positively correlated to IL-6 level so it correlated with severity of liver disease and hepatic fibrosis.