急性胰腺炎患者血清降钙素原和肿瘤坏死因子α及白介素8的动态变化及临床意义  

Dynamic Changes and Clinical Significance of Serum Procalcitonin,Tumor Necrosis Factor-α and Interleukin-8 in Patients with Acute Pancreatitis

作　　者：程刚[1] 陆士奇[1] 李岩[2] 

机构地区：[1]苏州大学附属第一医院急诊科,江苏省苏州市215006 [2]昆山市中医医院

出　　处：《中国全科医学》2012年第27期3180-3182,共3页Chinese General Practice

摘　　要：目的观察急性胰腺炎(AP)患者降钙素原(PCT)、肿瘤坏死因子α(TNF-α)及白介素8(IL-8)的动态变化,探讨其判断AP病情程度及有无合并感染的意义。方法选择苏州大学附属第一医院和昆山市中医医院2009年10月—2011年10月AP患者56例,其中轻症急性胰腺炎(MAP)患者21例(MAP组),重症急性胰腺炎(SAP)患者35例(SAP组);以SAP组合并胰腺感染患者5例为感染组,非感染者30例为非感染组。采用双抗体夹心免疫发光法检测患者入院时、第3天、第7天血清PCT水平,酶联免疫吸附法检测血清TNF-α和IL-8水平。结果入院时SAP组血清PCT、TNF-α及IL-8水平均高于MAP组,差异均有统计学意义(P<0.01);入院第3天两组血清PCT、TNF-α及IL-8水平达到高峰,SAP组血清PCT、TNF-α及IL-8水平仍高于MAP组,差异均有统计学意义(P<0.05);入院第7天两组血清PCT、TNF-α及IL-8水平有所下降,但SAP组血清PCT、TNF-α及IL-8水平仍高于MAP组,差异均有统计学意义(P<0.05)。感染组血清PCT水平在入院时、第3天、第7天均高于非感染组,差异有统计学意义(P<0.01);感染组血清TNF-α和IL-8水平在入院时、第3天、第7天也高于非感染组,但差异均无统计学意义(P>0.05)。结论 TNF-α和IL-8可用以诊断SAP和MAP,但均不能用以判断是否合并感染。PCT不仅能在早期反映AP病情程度,还可以早期判断是否合并感染,有助于早期合理选择抗生素与预防感染。血清PCT、TNF-α及IL-8检测方法简单易行,准确度高,价格低廉,还可进行动态监测,有助于指导临床医生做出更合理的治疗。Objective To observe the dynamic changes of serum procalcitonin （ PCT）, tumor necrosis factor - α （TNF-α） and interleukin- 8 （IL- 8） in patients with acute pancreatitis （AP） and to investigate their significance in jud- ging AP severity and the occurrence of concurrent infection. Methods 56 AP patients admitted to the First Affiliated Hospital of Suzhou University and Kunshan Hospital of TCM from October 2009 to October 2011 were selected. Among the patients, 21 cases were mild acute pancreatitis （MAP, MAP group） and 35 cases were severe acute panereatitis （SAP, SAP group） . 5 patients in SAP group combined with pancreatic infection were involved into infection group and other 30 patients were involved into non - infection group. Serum PCTs on admission, the third day after admission, he seventh day after admission were determined by EL- MA and TNF - α and IL - 8 were determined by ELISA. Results The levels of serum PCT, TNF - α and IL - 8 in the SAP group were all significantly higher than those in the MAP group （ P 〈 0.01 ） . The levels of serum PCT, TNF - α and IL - 8 reached the peak level on the third day after admission in the two groups, but their levels in the SAP group were still significantly higher than those in the MAP group （P 〈 0. 05） . The levels of serum PCT, TNF - α and IL - 8 both reduced on the seventh day after admission, but their levels in the SAP group were still significantly higher than those in the MAP group （ P 〈 0.05 ） . The levels of serum PCT on admission, the third day after admission and the seventh day after admission in the infection group were all significantly higher than those of the non - infection group （ P 〈 0. 01 ） . The levels of TNF - α and IL - 8 on admission, the third day after admission and the seventh day after admission in the infection group were all higher than those of the non - infection group but without statistical significance （P 〉 0. 05 ） . Conclusion TNF - α and IL - 8 can be used for the diagno

关 键 词：胰腺炎 降钙素 肿瘤坏死因子Α 白细胞介素8 

分 类 号：R576.1[医药卫生—消化系统]