可溶性程序性死亡受体-1与重症急性胰腺炎并发持续炎症-免疫抑制-分解代谢综合征的相关性分析  

Analysis of the relationship between sPD-L1 and persistent inflammatory immunosuppressive catabolic syndrome in severe acute pancreatitis

作　　者：方琦 陶京 常剑 朱孔凡 荣愈平[1] 梅佩 FANG Qi;TAO Jing;CHANG Jian(Department of Pancreatic Surgery,Renmin Hospital,of Wuhan University,Hubei Province,Wuhan 430060,China)

机构地区：[1]武汉大学人民医院胰腺外科,430060

出　　处：《临床外科杂志》2020年第3期254-257,共4页Journal of Clinical Surgery

基　　金：国家自然科学基金资助项目(81702368)。

摘　　要：目的探讨发生持续炎症-免疫抑制-分解代谢综合征(persistent inflammation immunosuppression catabolism,PICS)的重症急性胰腺炎(severe acute pancreatitis,SAP)病人是否比未发生PICS者的免疫抑制更加严重,并为临床诊断和治疗PICS提供参考。方法本研究观察评估了63例SAP病人,依照PICS诊断标准,将SAP病人分为PICS组(23例)和非PICS组(40例)。发生院内继发感染则判为免疫抑制,收集临床资料。在规定时点采血测定绝对淋巴细胞计数(ALCs)和可溶性程序性死亡受体1(sPD-L1)水平。结果 PICS组病人继发感染发生率为100%,而非PICS组为27.5%(P<0.05)。与非PICS组相比,PICS组SAP病人在发病早期ALCs、sPD-L1水平无统计学差异(P>0.05)。2周后两组SAP病人的sPD-L1水平和ALCs计数均存在统计学差异(P<0.05)。结论 SAP病人均存在免疫抑制,其中PICS组病人的免疫抑制更严重,继发感染发生率高。Objective To observe and search whether the patients fall into SAP with PICS will suffer more serious immunosuppression or not compared with those without PICS through clinical and laboratorial evidence and offer the reference to clinical diagnosis.Methods This study was about 63 SAP patients.According to academic reports,SAP patients were divided into PICS group with 23 patients and non-PICS group with 40 cases.We considered patients occur immunosuppression if they suffered secondary infections.Blood samples were collected to examined concentrations of ALCs and spd-l1.Results Compared with the control group,the ALCS count of SAP patients decreased significantly within 3 weeks after admission(P < 0.05),and the level of SPD L1 increased significantly within 1 month.Secondary infections occurred overall in the PICS group,compared with only 27.5% in the non-PICS group(P<0.05).There was no statistical difference in ALCs and sPD-L1 between two groups in the early stage of onset of SAP.However,after 2 weeks there is significant difference in ALCs and sPD-L1 in SAP patients with PICS and without PICS.Conclusion SAP patients with PICS suffer from more severe immunosuppression with higher incidence of secondary infections.

关 键 词：重症急性胰腺炎 持续炎症-免疫抑制-分解代谢综合征 绝对淋巴细胞计数 可溶性程序性死亡受体1 免疫抑制 

分 类 号：R576[医药卫生—消化系统]