OBJECTIVETo investigate the profile of serum cortisol levels in patients with severe hepatitis.

METHODSFifty patients with viral hepatitis (including 30 severe hepatitis patients and 20 chronic hepatitis B patients) were enrolled in this present study. Serum cortisol concentration was tested using radioimmunoassay. Furthermore, liver function, coagulation and other related laboratory indices were also determined.

RESULTSSerum cortisol concentration of severe hepatitis group was lower than that of chronic hepatitis B group (P < 0.05) and lower than that of healthy controls (P < 0.05) serum cortisol concentration of severe hepatitis patients was significantly positively correlated with PTA (r = 0.445, P < 0.05); serum cortisol concentration has no relation with ALT in patients with severe hepatitis (P > 0.05), and serum cortisol concentration was significantly negatively correlated with the ratio of AST/ALT in patients with severe hepatitis (r = -0.367, P < 0.05). No significant relationship was found between serum cortisol concentration and total Bilirubin (P > 0.05). Serum cortisol concentration in death group of severe hepatitis was lower than that in survival group of severe hepatitis (P < 0.05). Of severe hepatitis patients with MELD score, the higher MELD score, the lower the cortisol concentration.

CONCLUSIONCortisol concentration decreased in patients with severe hepatitis, which was related to functional liver reserve and disease severity. Cortisol can be related to the prognosis of severe hepatitis patients.