内毒素在急性胰腺炎早期炎症反应中的作用  

The role of endotoxin in the early inflammatory response of acute pancreatitis

作　　者：谭超超[1] 朱燕[2] 罗文婷[3] 王宇鹏[2] 史苇[1] 

机构地区：[1]湖南省人民医院检验科,湖南长沙410005 [2]中南大学湘雅医学院检验系,湖南长沙410013 [3]湖南师范大学,湖南长沙410000

出　　处：《中国卫生检验杂志》2016年第7期974-977,共4页Chinese Journal of Health Laboratory Technology

基　　金：湖南省卫生厅科研立项(2013078)

摘　　要：目的探讨内毒素(ET)在急性胰腺炎早期炎症反应发生发展中的作用。方法分别收集急性胰腺炎患者76例以及26例健康者,采用酶联免疫吸附方法测定患者第1 d、第3 d、第7 d和第14 d炎症因子IL-10、IL-1β、IL-6和TNF-α血清水平,并采用LAL方法对患者各时间段血清ET水平进行测定,根据患者入院时ET浓度的高低进行分组,分析ET在急性胰腺炎炎症反应中的作用。结果 SAP组患者入院时的ET血清浓度显著高于MAP组及健康对照组,差异有统计学意义(P<0.05)。ET高浓度组炎症因子TNF-α、IL-1β、IL-6、IL-10以及MODS发生率显著高于低浓度组,差异有统计学意义(P<0.05)。ET与TNF-α、IL-1β、IL-6、IL-10的峰值进行相关分析,发现ET与IL-10和IL-6峰值均存在相关性。结论 ET可能参与了急性胰腺炎早期炎症反应,并与疾病的严重程度和预后相关。Objective To investigate the role of endotoxin in the development of the early inflammatory reaction in acute pancreatitis. Methods 76 cases of patients with acute pancreatitis and 26 healthy control patients were collected. The inflammatory factors（ IL- 10,IL- 1β,IL- 6,TNF- α） serum levels at the first,third,seventh and fourteenth day were measured respectively by ELISA,and their serum endotoxin levels in the periods were measured by LAL,respectively. The acute pancreatitis patients were grouped by the endotoxin serum levels on admission,and the role of endotoxin in the inflammatory response of facute pancreatitis was analyzed. Results The serum concentration of endotoxin on admission in SAP group was significantly higher than MAP group and the healthy control group,with the difference statistically significant（ P〈0. 05）. The inflammatory factors,TNF- α,IL- 1β,IL- 6,IL- 10 and the incidence of MODS in endotoxin acute pancreatitis group with high concentration was significantly higher than the low concentration group,with the differences statistically significant（ P〈0. 05）. Correlation between ET and the peak values of TNF- α,IL- 1β,IL- 6,IL- 10 was analyzed,the result indicated that there was a correlation between ET and peak value of IL- 10 and IL- 6. Conclusion The endotoxin may participate in the early inflammatory reaction in acute pancreatitis,and be correlated with the severity of disease and prognosis.

关 键 词：急性胰腺炎 内毒素 炎症因子 

分 类 号：R576[医药卫生—消化系统]