急性胰腺炎早期血清SAA、TNF-α的变化与新分类关系的研究  

Study on the relationship between serum SAA, TNF-α and new classification in early stage of acute pancreatitis

作　　者：黄尚书[1] 罗莉芸[1] 陈梅[1] HUANG Shangshu;LUO Liyun;CHEN Mei(General Surgery-,Gaoming District People＇s Hospital of Foshan City,Guangdong Province,Foshan 528500,China)

机构地区：[1]广东省佛山市高明区人民医院普外科,广东佛山528500

出　　处：《中国医药科学》2018年第19期201-204,共4页China Medicine And Pharmacy

基　　金：广东省佛山市医学类科技攻关项目(2015AB000964)

摘　　要：目的研究急性胰腺炎血清淀粉样蛋白A(SAA)及肿瘤坏死因子(TNF-α)在急性胰腺炎早期病程中的变化与新分类的关系,探讨SAA、TNF-α在急性胰腺炎早期病程中的临床实用价值。方法严格按照急性胰腺炎的新型分型标准,165例急性胰腺炎患者分为三组:轻症胰腺炎组(MAP,n=105)、中度胰腺炎组(MSAP,n=35)、重症胰腺炎组(SAP,n=25),分别测定患者入院时、入院后第24、48、72h共4个不同时期SAA、TNF-α的浓度,比较分析不同组患者各个时期血清中SAA、TNF-α的水平差异有无统计学意义。结果 (1)轻症组与中度、重症组的SAA、TNF-α在入院时均有显著异常增高。(2)入院48h,中度组与轻症组的SAA水平已经无显著性差异(P> 0.05),但中度组与重症组有显著性差异(P <0.05);而中度组与重症组的TNF-α水平仍然无显著性差异,中度组与轻症组有显著性差异(P <0.05)。(3)入院72h,中度组与轻症两组SAA、TNF-α之间的差异无著性(P> 0.05),中度组与重症组均有显著性差异(P <0.05)。结论联合检测血清SAA、TNF-α水平对早期判断急性重症胰腺炎的严重程度及转归有重要参考价值。其中SAA的变化更加反应急性胰腺炎的变化。Objective To study the relationship between the changes of serum amyloid A protein（SAA） and tumor Necrosis Faetor（TNF-α） in early stage of acute panereatitis and its new classification.To explore the clinical value of SAA and TNF-α in the early course of acute panereatitis. Methods Strictly according to the new classification criteria for acute panereatitis,165 patients with acute panereatitis were divided into 3 groups,mild panereatitis group （MAP,n=105）,modcratc panercatitis group （MSAP,n=35）,and severe panercatitis group （SAP,n=25）.Thc concentrations of SAA and TNF-α were measured in four different periods,at admission,at 24h,48h and 72h after admission.The serum levels of SAA and TNF-α in different groups were compared and analyzed. Results （1）SAA and TNF-α in the mild group,the moderate and severe group were significantly abnormally increased at admission.（2）At 48 hours after admission,there was no significant difference in SAA levels between the moderate group and the mild group （P〉 0.05）,but there was a significant difference between the moderate group and the severe group （P〈 0.05）.There was no significant difference in TNF-α levels between the moderate group and the severe group.There was a significant difference between the moderate group and the mild group （P〈 0.05）.（3）At 72 hours after admission,the difference between SAA and TNF-o- in the moderate group and the mild group was not significant （P〉 0.05）,and there was significant difference between the moderate group and the severe group （P〈 0.05）. Conclusion Combined detection of serum levels of SAA and TNF-α has important reference value for determining the severity and outcome of acute severe panereatitis.The changes in SAA are more responsive to changes in acute panereatitis.

关 键 词：血清淀粉样蛋白A 肿瘤坏死因子(TNF-α) 急性胰腺炎 

分 类 号：R576[医药卫生—消化系统]