外周血IL-6、TNF-α早期检测对急性胰腺炎相关肺损伤及其性质的临床预测价值  

Clinical Predictive Value of Early Detection of IL-6 and TNF-α in Peripheral Blood on Acute Lung Injury during Acute Pancreatitis and Its Severity

作　　者：林燕 张发钦 李海涛[2] LIN Yan;ZHANG Faqin;LI Haitao(Fuzhou Second Hospital Affiliated to Xiamen University,Fuzhou 350007,China)

机构地区：[1]厦门大学附属福州第二医院,福建福州350007 [2]解放军福州总医院

出　　处：《中国医学创新》2018年第30期1-4,共4页Medical Innovation of China

基　　金：福建省自然科学基金项目(2017J01321)

摘　　要：目的:探讨早期检测外周血白介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)对急性胰腺炎(AP)相关急性肺损伤(ALI)及其性质的临床预测价值。方法:选取发病72 h内于本院首次就诊的AP患者90例,根据有无发生ALI及其性质(一过性、持续性)将其分为non-ALI组和ALI组(一过性ALI亚组、持续性ALI亚组)。比较各组入院时、入院第3天外周血IL-6、TNF-α水平。结果:本组47例(52.2%)未发生ALI(non-ALI组),43例(47.8%)发生ALI(ALI组),其中18例(41.9%)为一过性ALI(一过性ALI亚组)、25例(58.1%)为持续性ALI(持续性ALI亚组);入院时、入院第3天,ALI组IL-6、TNF-α水平均高于non-ALI组(P<0.05);入院第3天,ALI组IL-6、TNF-α均高于入院时(P<0.05),但non-ALI组与入院时比较差异均无统计学意义(P>0.05)。进一步亚组分析显示,入院第3天,持续性ALI亚组IL-6、TNF-α水平均高于入院时(P<0.05),但一过性ALI亚组与入院时比较差异均无统计学意义(P>0.05)。结论:早期检测外周血IL-6、TNF-α水平可以预测AP相关ALI的发生,并有助于评判ALI严重程度和转归情况。Objective:To explore the clinical predictive value of early detection of IL-6 and TNF-αin peripheral blood on acute lung injury(ALI)during acute pancreatitis(AP)and its severity.Method:A total of 90 AP patients who visited the hospital for the first time within 72 h were selected.According to the occurrence of ALI and its nature(transient,persistent),they were divided into non-ALI group and ALI group(transient ALI subgroup,persistent ALI subgroup).The levels of peripheral blood IL-6 and TNF-αat admission and the third days after admission between each group were compared.Result:There were 47 cases(52.2%)without ALI(non-ALI group),43 cases(47.8%)with ALI(ALI group),among them,18 cases(41.9%)were transient ALI(transient ALI subgroup)and 25 cases(58.1%)were persistent ALI(persistent ALI subgroup).On admission and the third days after admission,the levels of IL-6 and TNF-αin ALI group were higher than those of non-ALI group(P<0.05),on the third days after admission,the levels of IL-6 and TNF-αin ALI group were higher than those of admission(P<0.05),but the non-ALI group were compared with admission,the differences were not statistically significant(P>0.05).Further subgroup analysis showed that the levels of IL-6 and TNF-αin persistent ALI subgroup on the third days after admission were higher than those at admission(P<0.05),but the transient ALI subgroup were compared with admission,the differences were not statistically significant(P>0.05).Conclusion:Early detection of peripheral blood IL-6 and TNF-αlevels can predict the occurrence of ALI in AP,and help to evaluate the severity and prognosis of ALI.

关 键 词：急性胰腺炎 急性肺损伤 白介素-6 肿瘤坏死因子-Α 

分 类 号：R576[医药卫生—消化系统]