巨噬细胞在急性重症胰腺炎继发感染中的机制研究  

The mechanism of macrophages in prognosis of severe acute pancreatitis with secondary infection

作　　者：张明刚[1] 段军[2] 陶永康[3] 杨华元[1] 杜时雨[1] 

机构地区：[1]中日友好医院消化内科,北京100029 [2]中日友好医院重症医学科,北京100029 [3]中日友好医院急诊科,北京100029

出　　处：《胃肠病学和肝病学杂志》2017年第2期207-209,共3页Chinese Journal of Gastroenterology and Hepatology

摘　　要：目的分析受试者外周血中巨噬细胞的活化状态与急性重症胰腺炎(severe acute pancreatitis,SAP)患者继发感染的相关性。方法 132例SAP患者入选,根据是否继发感染分为感染组和未感染组,并以健康对照者作为对照组。在继发感染初期,用酶联免疫检测方法检测血清中促炎因子肿瘤坏死因子-α(TNF-α)、白介素-6(IL-6)和白介素-1β(IL-1β)的浓度;用流式细胞术检测外周血中巨噬细胞百分率和刺激分子的表达及分泌上述促炎因子的变化。结果感染组和未感染组的血清中促炎因子TNF-α、IL-1β,较健康对照组均升高;巨噬细胞的比例及数量较健康对照组也明显增多;MHC-Ⅱ、CD86、TNF-α+细胞、IL-1β+细胞的比例也较健康对照组均升高,且感染组的各项指标均明显高于未感染组(P<0.05)。结论 SAP的发生和继发感染与巨噬细胞的活化密切相关,继发感染后巨噬细胞的活化增强。Objective To investigate the relationship between macrophages activation state in the blood and secondary infection from severe acute pancreatitis（ SAP）. Methods One hundred and thirty-two patients with SAP were divided into infection group and uninfection group,compared with healthy control group. Serum levels of tumor necrosis factor-α（ TNF-α）,interleukin-6（ IL-6）,interleukin-1β（ IL-1β） were determined by ELISA. The frequency and activation of macrophages in the blood and the production of cytokines such as TNF-α,IL-6 and IL-1β were detected by FCM. Results Compared with healthy control group,the inflammatory indicators,such as density of TNF-α,IL-6,IL-1β in the serum and the number,ratio of macrophages were increased in infection group and uninfection group. The activation of macrophages which was represented as expression of MHC-Ⅱ,CD86,ratio of TNF-α＋cells and IL-1β＋were also increased sequentially（ P〈0. 05）. Conclusion The pathogenesis of SAP and secondary infection are closely related to the activation of macrophages. Macrophages emerges an enhanced activation after secondary infection.

关 键 词：急性重症胰腺炎 巨噬细胞 继发感染 固有免疫 

分 类 号：R576[医药卫生—消化系统]