重症急性胰腺炎并发感染患者Th17变化研究  

Change of Th17 cells in severe acute pancreatitis patients complicated with infection

作　　者：陶静[1] 颜碧清[1] 殷颖杰[1] 黄钦 方晶晶[1] 史超路[1] TAO Jing;YAN Bi-qing;YIN Ying-jie;HUANG Qin;FANG Jing-jing;SHI Chao-lu(The Affiliated Hospital of Medical School of Ningbo University , Ningbo , Zhejiang 315020, China)

机构地区：[1]宁波大学医学院附属医院ICU

出　　处：《中华医院感染学杂志》2019年第13期2004-2007,共4页Chinese Journal of Nosocomiology

基　　金：宁波市科技计划基金资助项目(2013C50043)

摘　　要：目的探索Th17细胞与其细胞因子在重症急性胰腺炎并发感染患者中的变化。方法选取2013年7月-2018年7月于医院接受治疗的60例重症胰腺炎患者为病例组,另外选取同期于医院体检的68名健康体检者作为对照组。采集各组血液并检测外周血Th17细胞百分比、白细胞介素-6(IL-6)、IL-17、IL-23以及转化生长因子-β1(TGF-β1)指标水平。结果感染组ICU平均住院天数为(14.62±1.58)天,病死率为23.08%明显高于未感染组ICU平均住院天数(6.92±0.69)天和病死率2.94%(P<0.05)。感染组和未感染组Th17细胞百分比、IL-6、IL-17、IL-23、TGF-β1指标水平明显高于对照组,感染组Th17细胞百分比、IL-6、IL-17、IL-23、TGF-β1显著高于未感染组(P<0.05)。本次研究26例重症胰腺炎并发感染患者共检测出34株病原菌,其中革兰阴性菌23株占比67.65%,革兰阳性菌9株占比26.47%,真菌2株占比5.88%。结论重症急性胰腺炎并发感染患者外周血Th17分泌量明显上升,患者出现免疫亢进后ICU住院天数以及病死率显著上升,感染患者主要感染病原菌为革兰阴性菌。OBJECTIVE To explore the changes of Th17 cells and their cytokines in severe acute pancreatitis patients complicated with infection. METHODS A total of 60 patients with severe pancreatitis who were treated in the hospital from Jul 2013 to Jul 2018 were chosen as the case group, meanwhile, 68 healthy people who received physical examination were chosen as the control group. The blood specimens were collected, and the percentage of Th17 cells and levels of interleukin-5(IL-6), IL-17, IL-23 and transforming growth factor-β1(TGF-β1) in peripheral blood were determined. RESULTS The average length of ICU stay of the infection group was(14.62±1.58) days, significantly longer than(6.92±0.69) days of the non-infection group;the mortality rate of the infection group was 23.08%, significantly higher than 2.94% of the non-infection group(P<0.05). The percentage of Th17 cells and levels of IL-6, IL-17, IL-23 and TGF-β1 were significantly higher in the infection group and the non-infection group than in the control group;the percentage of Th17 cells and levels of IL-6, IL-17, IL-23 and TGF-β1 were significantly higher in the infection group than in the non-infection group(P<0.05). Totally 34 strains of pathogens were isolated from the 26 severe acute pancreatitis patients complicated with infection, 23(67.65%) of which were gram-negative bacteria, 9(26.47%) were gram-positive bacteria, and 2(5.88%) were fungi. CONCLUSION The percentage of peripheral blood Th17 cells is significantly elevated in the severe acute pancreatitis patients complicated with infection;after immunization, the length of ICU stay is significantly extended, and the mortality rate is remarkably increased. The gram-negative bacteria are dominant among the pathogens causing the infection.

关 键 词：TH17细胞 细胞因子 重症胰腺炎并发感染 改变情况 

分 类 号：R576[医药卫生—消化系统]