急性胰腺炎肝损害与血清白细胞介素-6的关系临床观察  

Clinical Observation of Relationship Between Acute Pancreatitis Liver Damage and Interleukin-6

作　　者：陈畅[1] 张文俊[2] 龚发良[1] 雷银雪[1] 刘岩[2] 

机构地区：[1]湖北省宜昌市第一人民医院消化内科,宜昌443000 [2]第二军医大学长海医院消化内科,上海200433

出　　处：《武汉大学学报（医学版）》2006年第4期510-513,共4页Medical Journal of Wuhan University

摘　　要：目的:研究急性胰腺炎(AP)肝损害与血清IL-6水平的关系。方法:96例AP患者分轻、重症(MAP、SAP)两组,设正常对照组34例。采集AP患者入院24 h内及出院前1 d空腹静脉血,对照组空腹静脉血,测定血清肝功能指标(ALT、AST、TB、ALB、LDH、AKP、γ、GT)及IL-6水平。结果:96例AP患者合并肝功能损害58例(60.42%)。AP患者与对照组比较,治疗前SAP组与MAP组比较,血清各肝功能指标水平有显著差异(P<0.01)。治疗后SAP患者的血清ALB较治疗前升高(P<0.05),SAP组和MAP组肝功能其他指标水平均明显下降(P<0.05)。血清IL-6水平AP组显著高于对照组(P<0.01),治疗后明显低于治疗前(P<0.01);AP合并肝损害患者组显著高于对照组及无肝损害患者组(P<0.01)。AP肝损害患者的血清IL-6水平与血清ALT、AST正相关(r=0.64,P<0.01;r=0.58,P<0.01),与其他肝功能指标无相关性。对AP严重程度预测ΔALT=-20.50U/L、ΔAST=-8.50 U/L、ΔIL-6=-36.23 ng/L时灵敏度、特异度较高。结论:AP肝损害发生率高,SAP肝损害严重程度明显高于MAP,AP肝损害患者血清IL-6水平明显升高,且升高程度与病情严重程度呈正相关。对AP严重程度预测,ΔALT及ΔAST指标灵敏度、特异度较显著,ΔIL-6有一定意义。Objective： To research the relationship between acute pancreatitis （AP） liver damage and interleukin-6 （IL-6） levels in serum. Methods. Ninety-six acute pancreatitic patients were assigned into two groups as mild （MAP） and severe （SAP） group. Another 34 healthy controls were also involved in this study. The serum levels of ALT, AST, TB, ALB, LDH, AKP, γ,GT and IL-6 were compared among the two acute pancreatitis groups and the control group. The incidence rate of liver damage in 96 cases of acute pancreatitis was 60. 42 %. The serum levels of liver function either between SAP group and MAP group or between AP groups and control group were significantly different（all P〈0. 01） before treatment. In both AP groups, the serum levels of ALT, AST, TB, LDH, AKP, and γGT were all decreased but ALB levels in SAP were increased after treatment（all P〈0.05）. The serum levels of IL-6 in acute pancreatitis patients were higher than in control group（P〈0.01） and decreased after treatment（P〈0.01）. In AP patients with liver damage, and the IL-6 levels were much higher than in patients without liver damage and the controls（both P〈0.01）. The positive correlation was discovered between serum levels of IL-6 and ALT or AST among acute pancreatitic patients with liver damage（r=0. 64 ,P〈0.01 ,r=0.58,P〈0.01）,and IL-6 had no relations to the other indices. The sensitivity and specificity of the liver function changing indices such as △ALT=- 20. 50 U/L, △AST=-8. 50 U/L and △IL-6=-36.23 ng/L in predicting acute pancreatitis severity degree were higher in acute pancreatitis with liver damage patients. Conlcusion： The incidence rate of liver damage in acute pancreatitis was higher. The degrees of liver damagement in SAP were much higher than in MAP. The serum levels of IL-6 in acute pancreatitic patients were significantly higher and its changes were positively correlated with degrees in liver damage. The sensitivity and specificity of △ALT and AAST in acute pancreatitis with li

关 键 词：急性胰腺炎 肝损害 白细胞介素-6 

分 类 号：R576[医药卫生—消化系统]