急性胰腺炎肝损害与血清IL-18、TNF-α、NO的关系  

Relationship between liver damage and serum levels of IL-18, TNF-α and NO in patients with acute pancreatitis

作　　者：梁坚[1] 周宇[1] 王壮[1] 陈洁[2] 

机构地区：[1]广东医学院附属医院消化内科,广东湛江524001 [2]广东医学院附属医院检验科,广东湛江524001

出　　处：《南方医科大学学报》2010年第8期1912-1914,共3页Journal of Southern Medical University

摘　　要：目的探讨急性胰腺炎(AP)肝损害与IL-18、TNF-α、NO变化的关系。方法 87例AP患者分轻、重型(MAP、SAP)两组,设正常对照组50例,采用ELISA检测IL-18、TNF-α水平,采用硝酸还原酶法检测NO水平,同时测定血清肝功能指标(ALT、AST、TB、ALB、LDH、AKP、γ-GT)。结果 87例患者合并肝功能损害者54例(62.06%)。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组血清ALB较治疗前升高(P<0.01),SAP组和MAP组肝功能其他指标均明显下降(P<0.01);血清IL-18、TNF-α、NO水平AP组显著高于对照组(P<0.01),治疗后显著低于治疗前(P<0.01);AP合并肝损害组显著高于对照组及无肝损害组(P<0.0);AP肝损害患者血清IL-18、TNF-α、NO与血清ALT、AST呈正相关,IL-18与TNF-α、NO呈正相关。结论 AP患者肝损害发生率高,SAP肝损害程度明显高于MAP,AP肝损害患者血清IL-18、TNF-α、NO水平明显升高,升高程度与病情严重程度呈正相关;检测血清IL-18、TNF-α、NO可作为AP肝损害诊断、判断病情程度及预后的指标。Objective To study the relationship between liver damage and the serum levels of interleukin-18 （IL-18）, tumor necrosis factor-α （TNF-α） and NO in patients with acute pancreatitis （AP）. Methods Eighty-seven AP patients were divided into mild AP （MAP） and severe AP （SAP） groups, with 50 healthy subjects serving as the controls. The serum levels of IL-18 and TNF-α were determined by ELISA, and NO level was measured by nitrate reductase method. The serum levels of ALT, AST, TB, ALB, LDH, AKP and γ-GT were also measured. Results The incidence of liver damage was 62.06% in these patients. The serum markers of the liver function differed significantly between the AP patients and the control subjects and between SAP and MAP groups before the treatment （P〈0.01）. The ALB level in SAP group increased significantly after the treatment （P〈0.01）, and the other indices of the liver function all decreased in both MAP and SAP groups （P〈0.01）. The serum levels of IL-18, TNF-α and NO were higher in the AP patient than in the control subjects （P〈0.01）, and decreased significantly after the treatment （P〈0.01）. In AP patients with liver damage, the levels of IL-18, TNF-α and NO were obviously higher than those in patients without liver damage and the control group （P〈0.01）. In AP patients with liver damage, the serum levels of IL-18, TNF-α, and NO were positively correlated to ALT and AST levels, and IL-18 was positively correlated to TNF-α and NO. Conclusion AP patients have high incidence of liver damage, which is obviously severer in SAP than in MAP patients. The serum levels of IL-18, TNF-α and NO are positively correlated to the severity of liver damage in the AP patients, and can be used as indictors for early diagnosis, evaluation of the severity and prognosis of liver damage.

关 键 词：急性胰腺炎 肝损害 白细胞介素-18 肿瘤坏死因子-Α 一氧化氮 

分 类 号：R576[医药卫生—消化系统]