Chronic liver disease have done great harm to humans, the main cause is hepatitis B virus infection。According to the population of different regions in the world and the rate of hepatitis B surface antigen carrier, it is estimated that there are 350 million carriers of HbsAg in the whole world, while there are 1.2 billions in china, our country is a region of high incidence of hepatitis B, which accounting for above 1/3 of the hepatitis B carriers worldwide. After hepatitis B virus infection, with the exception of the occurrence of acute and chronic hepatitis, it can become chronic virus carrier easily, and also can lead to chronic hepatitis, cirrhosis, primary hepatocellular carcinoma, done serious threat to the health of our people. However, in recent years,people have found that nonalcoholic steatohepatitis (NASH) and nonalcoholic fatty liver disease (NAFLD) from the past as a matter of imaging findings seen in such as type-B ultrasound and CT examination conclusions, until Day et al found that the evolution of NASH to liver fibrosis and cirrhosis in 1998, NASH academic side has been of great concern. Gradually in 2002 people recognized that NAFLD doesn’t do harm to the liver only, it acts as "risk factor" for the promotion of metabolic disorders should not be underestimated, NAFLD may be another important component of the metabolic syndrome. With obesity and diabetes increasing, NAFLD has become the primary cause of chronic liver disease in the Western developed countries, and showed trends in the incidence of globalization. China has a large population, with the continuous improvement of living standards, NAFLD is significantly higher morbidity, it has become the second largest second only to chronic viral liver disease.With the obesity and metabolic syndrome prevalence in the world and its trends in the incidence of younger age, NAFLD has become the new challenges of the field of liver disease, pose a serious threat to human health and social development.Ghrelin,a endogenous ligand of growth hormone secretagogue receptor ligand ,is a endogenous peptides containing 28 amino acids. It plays a wide range of biological role,sunch as adjusting the release of some hormones, such as GH, prolactin, adrenalin,to maintain hormone balance in the body; promoting food intake, reducing fat use,impacting energy metabolism; regulating blood flow dynamics to reduce the mean arterial pressure, increasing heart index and cardiac output; regulating gastric motility and gastric acid secretion, playing a role in gastric mucosal protection; inhibiting tumor cell proliferation.Recent study found that, Ghrelin is closely related to insulin and glucolipid metabolism, the level of low-Ghrelin can be used as a risk factor of type 2 diabetes and impaired glucose tolerance. It promotes feeding in vivo through the central appetite regulatory network, in particular, neuropeptide Y; and interacts with a variety of obesity-induced factors such as leptin, insulin, plays an important role in the pathological process of obesity.There is a similar phenotype of the metabolic abnormalities in insulin resistance, but in the mechanism, the occurrence of insulin resistance is associated with too much secretion of pro-inflammatory fatty cytokines such as TNF-α,IL-6,FFA, or suppression of inflammatory cytokines in the absence of fat, loss of protective effect of antagonisming ectopic deposition of fat. The insulin resistance of NAFLD patients is closely related to these factors.,The existence of impaired glucose metabolism and lipid metabolic abnormalities in NAFLD patients can further lead to the accumulation of triglycerides in the liver, which in turn further contribute to impaired glucose metabolism and decreased insulin sensitivity. Combination reports in the literature,in the process of NAFLD occurred, the existence of hyperinsulinemia and insulin resistance, these abnormal changes may form a vicious cycle which is an important cause of difcuty to reverse fatty liver.Chronic hepatitis, liver cirrhosis patients mainly prosess enhanced catabolism, changes of fatty acid, ketone body,insulin and catecholamines, in cycle may regulate Ghrelin secretion in gastro by some way; In addition, patients with liver cirrhosis often complicated by portal hypertension gastropathy, which makes the synthesis of Ghrelin increased in gastro,after secretion into the blood circulation, resulting the expression level increased of Ghrelin in peripheral blood of patients with liver cirrhosis.Are of the view that the mechanism of decompensate cirrhosis occurrence is concerned with in addition to intrahepatic hemodynamics barriers, liver dysfunction, reduced serum albumin, colloid osmotic pressure reduction, but also to changes in renal hemodynamics and activation of neurohumoral factors. Ghrelin,a hormone in vivo, stimulates growth hormone releasing, and also relates with the secretion of many hormones, Ishizaki S etal, caused concentration increased of Arginine vasopressin in blood through intravenous injection for the rat brain indoor, and the relationship between these two showed a dose-dependent manner. AVP plays an important role in decompensate cirrhosis formation, and studies have shown that peroral AVP receptor antagonists can treat the water retention effectly in the patients with cirrhosis. A large number of studies have shown that patients with liver cirrhosis present high GH levels, the abnormal secretion of GH in liver cirrhosis may be associated with higher levels of the Ghrelin.Ghrelin,as a hunger signal,can stimulate the central hypothalamus regulation of energy,so that the body by enhancing the appetite, increasing food intake improve their nutritional status.Ghrelin can also stimulate the secretion of GH, promote protein synthesis,maintain positive nitrogen balance; promote gluconeogenesis, increase serum glucose, so as to improve the nutritional status of the body. However, the increasing concentration of Ghrelin seems does poor improvement to the the malnutrition of liver cirrhosis in patients,it may be due to that the body exist resistance Ghrelin in the pathological state,so that cause the reduces of biological role of Ghrelin, meanwhile,Ghrelin co-work with other antagonistic hormones,for example leptin,so that makes further compensatory expression of the Ghrelin, these results above all may lead to increasing serum levels of Ghrelin.At present the study of Ghrelin and liver disease seen mainly in Ghrelin\'s role in liver cirrhosis, as well as the relationship between Ghrelin and non-alcoholic fatty liver disease.This experiment explored relationship and clinical significance among Ghrelin,liver damage,the occurrence of complications in patients distinguished with chronic hepatitis B,hepatitis cirrhosis,non-alcoholic fatty liver disease through detecting the expression level of Ghrelin and inflammatory cytokines TNF-α,IL-1 and IL-6 in peripheral blood.Objective:peripheral Ghrelin and inflammatory cytokines TNF-α, IL-1 and IL-6 expression levels and chronic hepatitis B, liver cirrhosis, non-alcoholic fatty liver disease and complications of liver damage occurred in the relationship and its clinical significance. Methods:ELISA was used to detect Ghrelin, TNF-α, IL-1 and IL-6 in normal subjects and patients.Results:In chronic hepatitis B and hepatic cirrhosis,Ghrelin increased significantly, compared with normal control group (P<0.05).In liver cirrhosis (B、C level)group, Ghrelin levels in peripheral blood of patients with chronic B was significant higher than that hepatitis group (P<0.001).Ghrelin,in non-alcoholic fatty liver disease group, decreased significantly compared with normal control group (P <0.05). In chronic hepatitis and liver cirrhosis groups, Ghrelin and inflammatory cytokines,including TNF-α, IL-1 and IL-6 were positively correlated, but in the NAFLD group were negatively correlated.Conclusion:The higher expression dgree of Ghrelin,in peripheral blood of chronic hepatitis B and hepatic cirrhosis patients, is closely related to the liver damage and occurrence of complications. Dynamic changing of Ghrelin expression levels made it clear that Ghrelin participated in the occurrence and development process of chronic hepatitis B and hepatic cirrhosis patients. Ghrelin, in non-alcoholic fatty liver disease, decreased significantly, which is a combination of multiple factor, a more important initiating agent may be metabolic abnormalities,for example,hormone imbalance in metabolism,that significantly reduced the role of Ghrelin in anti-inflammatory and protection mechanisms of liver cells, which may be particularly important in the occur and development of NAFLD. Ghrelin and inflammatory cytokines,including TNF-α, IL-1 and IL-6 were positively correlated, but in the NAFLD group were negatively correlated,it shows that Ghrelin acts mainly as anti-inflammatory in hepatitic cirrhosis and its complications formation,but for the result of reduced expression, maked weaken of the protective mechanisms of liver cells, which thereby promote the occurrence of NAFLD.