SPINK1基因多态性对乌司他丁治疗急性胰腺炎疗效的影响  

Influence of SPINK1 Gene Polymorphism on Efficacy of Ulinastatin in Treatment of Acute Pancreatitis

作　　者：李红[1] 胡志军[1] LI Hong;HU Zhijun(Department of Spleen,Stomach and Liver Diseases,Baoji Hospital of Traditional Chinese Medicine,Baoji,Shaanxi Province 721000)

机构地区：[1]陕西省宝鸡市中医医院脾胃肝病二科

出　　处：《胃肠病学》2019年第6期345-349,共5页Chinese Journal of Gastroenterology

摘　　要：背景:乌司他丁是急性胰腺炎(AP)的重要治疗药物,然而不同患者的疗效具有一定差异。目的:探讨SPINK1基因多态性对乌司他丁治疗AP疗效的影响。方法:纳入2005年1月—2015年12月宝鸡市中医医院收治的AP患者572例,静脉滴注乌司他丁100000U治疗。采用PCR法检测SPINK1基因多态性,ELISA法检测血清TNF-α、IL-2、IL-8、IL-10以及血尿淀粉酶水平,并评估乌司他丁的疗效。结果:AP患者c.101A>G位点突变率明显高于对照组(P<0.05)。c.200G>A位点突变的SPINK1mRNA表达显著降低(P<0.05)。c.36G>C、c.200G>A位点突变的黄疸缓解率均显著低于野生型(P<0.05)。c.200G>A位点突变的TNF-α、IL-8水平显著低于野生型(P<0.05)。c.200G>A组患者血尿淀粉酶阳性数减少的趋势较平缓。c.36G>C、c.200G>A位点突变的治疗有效率显著低于野生型(P<0.05)。结论:AP患者c.101A>G突变率高于普通人群,c.36G>C、c.200G>A位点突变能影响乌司他丁对AP患者的疗效。Background: Ulinastatin is an important drug for the treatment of acute pancreatitis (AP). However, there are some differences in the efficacy of ulinastatin among different patients. Aims: To explore influence of SPINK1 gene polymorphism on the efficacy of ulinastatin in treatment of AP. Methods: A total of 572 patients with AP from January 2005 to December 2015 at Baoji Hospital of Traditional Chinese Medicine were enrolled. Ulinastatin 100 000 U was given intravenously. Mutation of SPINK1 gene was detected by PCR. The levels of TNF-α, IL-2, IL-8, IL-10 and blood, urine amylase were determined by ELISA. The efficacy of ulinastatin was evaluated. Results: Rate of c.101A>G mutation in AP patients was significantly higher than that in the control group ( P < 0.05 ). c.200G>A mutation resulted in a significant decrease of SPINK1 mRNA expression ( P <0.05). The remission rate of jaundice was significantly lower in AP patients with c.36G>C and c.200G>A mutations than in wild type ( P < 0.05 ). The levels of TNF-α, IL-8 in c.200G>A mutation were significantly decreased than those in wild type ( P < 0.05 ). The decrease trend of positive amylase in blood and urine was weaker in AP patients with c.200G>A mutation ( P <0.05). The efficacy rate in AP patients with c.36G> C and c.200G>A mutations was significantly lower than that in wild type ( P < 0.05 ). Conclusions: The rate of c.101A>G mutation in patients with AP is higher than that in general population. Mutations of c. 36G>C and c.200G>A could influence the efficacy of ulinastatin for the treatment of AP.

关 键 词：基因 SPINK1 多态性 单核苷酸 乌司他丁 急性胰腺炎 治疗 

分 类 号：R576[医药卫生—消化系统]