吲哚美辛栓对ERCP术后血清淀粉酶、炎症因子和免疫功能的影响  

Effects of indomethacin suppositories on serum amylase,inflammatory factors and immune function after endoscopic retrograde cholangiopancreatography(ERCP

作　　者：彭晓斌[1] 王小云[1] 吴高珏[1] 胡臻[1] 唐栓 龚镭[1] 

机构地区：[1]无锡市第二人民医院消化内科,江苏无锡214000

出　　处：《海南医学院学报》2016年第19期2290-2293,共4页Journal of Hainan Medical University

基　　金：无锡市第六批科技发展计划项目(CSE01N1217)~~

摘　　要：目的:探讨吲哚美辛栓对内镜逆行胰胆管造影(ERCP)术后血清淀粉酶、炎症因子和免疫功能的影响。方法:将85例需行ERCP治疗的胆总管结石或梗阻性黄疸患者按照治疗方法不同分为观察组(n=45)和对照组(n=40),两组均进行ERCP治疗,观察组于术前30 min给予吲哚美辛栓50 mg肛塞。检测术前、术后6h以及术后24h血清淀粉酶,炎症因子:白细胞介素-6(IL-6)、白细胞介素-10(IL-10)、肿瘤坏死因子-α(TNF-α)以及白细胞介素-4(IL-4),T细胞亚群:CD3^+、CD4^+、CD8^+,计算CD4^+/CD8^+。结果:两组术后6、24h血清淀粉酶均较术前显著升高,且观察组术后6、24h血清淀粉酶显著低于对照组相同时间点,差异均有统计学意义(P<0.05)。两组术后6、24h血清促炎因子IL-6、TNF-α先升高后降低,且显著高于术前;两组术后6、24h血清抗炎因子IL-10、IL-4逐渐升高,且显著高于术前,差异均有统计学意义(P<0.05);观察组与对照组术后6、24h相同时间点比较发现,观察组抗炎因子IL-10、IL-4显著升高,促炎因子IL-6、TNF-α显著降低,两组间比较具有统计学差异(P<0.05)。两组术后6、24hT细胞亚群CD3^+、CD4^+、CD4^+/CD8^+先降低后升高,且显著低于术前,差异有统计学意义(P<0.05);观察组术后6、24hCD3^+、CD4^+、CD4^+/CD8^+显著高于对照组相同时间点,差异有统计学意义(P<0.05)。结论:吲哚美辛栓可以降低ERCP术后血清淀粉酶,减轻炎症反应,调节免疫功能。Objective：To explore the effects of Indomethacin Suppositories on serum amylase, inflammatory factors and immune function after endoscopic retrograde cholangiopancreatography （ERCP）. Methods.. A total of 85 cases patients with common bile duct stones or obstructive jaundice were divided into the observation group （n =45） and the control group （n = 40） according to the different treatment methods both two groups patients were treated with ERCP, patients in the observa- tion group was given indomethacin suppositories 50 mg preoperative 30 min. Serum amylase, inflammatory factors and T cellsubsets were detected preoperative, postoperative 6 h and postoperative 24 h. Inflammatory factors including interleukin-10 （IL-10）, interleukin-6 （IL-6）, tumor necrosis factor alpha （TNF-α） and interleukin-4 （IL-4）. T cell subsets including CD3＋ , CD4＋ , CD8＋ and calculated CD4＋/CD8＋ . Results： both two groups postoperative 6h, 24 h serum amylase were signiFicantly higher than before surgery; in the observation group, the postoperative 6 h, 24 h serum amylase were significantly lower than in the control group at the same time point （P〈0.05）. Both two groups postoperative 6 h, 24 h serum pro--inflammatory fac- tor IL-6 and TNF-α increased first and then decreased, both were significantly higher than before surgery; both two groups postoperative 6 h, 24 h serum anti--inflammatory factor IL-10 and IL-4 gradually increased, both were significantly higher than before surgery （P〈0.05） ; in the observation group, anti-inflammatory factor IL-10 and IL-4 significantly increased while pro--inflammatory factor IL-6 and TNF-α significantly decreased compared with the control group at the same time point 6 h and 24 h after surgery （P〈0.05）. Both two groups postoperative 6 h, 24 h T cell subsets CD3＋ , CD4＋ , CD44 /CD8＋ first decreased and then increased, all were significantly lower than before surgery （P〈0.05） ; in the observation group, the post- operative 6 h, 24 h

关 键 词：吲哚美辛栓 内镜逆行胰胆管造影 淀粉酶 炎症因子 免疫功能 

分 类 号：R657.4[医药卫生—外科学] R657.5[医药卫生—临床医学]