急性胰腺炎时促炎症因子和抗炎症因子的变化及其意义  

Observation on serum interleukin′s alteration in patients with acute pancreatitis

作　　者：尚东[1] 关凤林[1] 陈海龙[1] 李克军[1] 王锋[1] 刘忠[1] 王春敏[1] 胡爱萍[1] 

机构地区：[1]大连医科大学附属第一医院普外科,116011

出　　处：《中华普通外科杂志》2002年第4期226-226,共1页Chinese Journal of General Surgery

摘　　要：目的研究急性胰腺炎全身炎性反应综合征 (systemicinflammatoryresponsesyndrome,SIRS)时促炎因子和抗炎因子的变化及其意义。方法本组 32例急性胰腺炎患者中轻症急性胰腺炎 (mildacutepancreatitis,MAP) 13例 ,重症急性胰腺炎 (severeacutepancreatitis,SAP) 19例。观察入院后第 1、3、5、7日急性生理和既往健康评分 (APACHEⅡ )、BalthazarCT评分、血清白细胞介素 (IL) 6、IL 8、IL 10和IL 12的变化。结果入院第 1日MAP组APACHEⅡ评分和BalthazarCT评分分别为(5 6± 2 1)和 (1 5± 0 6 ) ,SAP组为 (13 6± 4 3)和 (6 3± 1 5 ) ,2组APACHEⅡ评分和BalthazarCT评分的差异均有显著意义 (P值均 <0 0 1) ;入院第 1日MAP组患者血清IL 6、IL 8、IL 10、IL 12的水平分别为 (9± 3)pg/ml、(4 1± 16 )pg/ml、(7 9± 2 3)pg/ml、(12 9± 30 )pg/ml,SAP组分别为 (6 4± 14)pg/ml、(5 1± 18)pg/ml、(6 9± 1 7)pg/ml、(6 4± 14)pg/ml,2组IL 10 /IL 6、IL 12 /IL 6、IL 12 /IL 8的比值差异有显著意义 (P值均 <0 0 1)。结论IL 6、IL 8和IL 10、IL 12的表达水平与急性胰腺炎的严重度有关 ,综合BalthazarCT评分。Objective To study the clinical significance of the proinflammatory cytokines and anti-inflammatory cytokines in acute pancreatitis with systemic inflammatory response syndrome. MethodsIn this study, 13 cases of mild acute pancreatitis (MAP), and 19 cases of severe acute pancreatitis(SAP) were recruited to evaluate acute physiology and chronic health evaluation (APACHEⅡ) on post admission day 1,3,5,7 and Balthazar CT criteria on post admission day 1,7. Values of serum IL-6?IL-8?IL-10?IL-12 were measured. ResultsThe scores of APACHEⅡ and Balthazar CT criteria were lower in the MAP patients than those in the SAP patients(5.6±2.1 and 1.5±0.6 vs. 13.6±4.3 and 6.3±1.5, all P<0.01). The levels of IL-6?IL-8?IL-10?IL-12 on post admission day 1 in the MAP patients was (9±3)?pg/ml,(41±16)?pg/ml,(7.9±2.3)?pg/ml,(129±30)?pg/ml, and that in the SAP patients was (64±14)?pg/ml,(51±18)?pg/ml,(6.9±1.7)?pg/ml,(64±14)?pg/ml. The ratio of IL-10/IL-6, IL-12/IL-6 and IL-12/IL-8 were significantly different between MAP patients and SAP patients (P<0.01). ConclusionsThe results revealed that levels of IL-6?IL-8?IL-10?IL-12 were in correspondence with the severity of acute pancreatitis.Mesurement of serum interlukins may have a prognostic significance.

关 键 词：急性胰腺炎 白细胞介素类 全身炎性反应综合征 促炎症因子 抗炎症因子 临床意义 

分 类 号：R657.51[医药卫生—外科学]