急性胰腺炎多种细胞因子检测对患者预后的评估

Prognosis evaluation of various cytokine detection in acute pancreatitis

目的:检测急性胰腺炎(AP)患者血清中白细胞介素-1(IL-1)、白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)水平,探讨其在病情观察和预后评估中的作用。方法:选取发病时间小于24小时的AP患者58例,分为轻症急性胰腺炎(MAP)组39例,重症急性胰腺炎(SAP)19例两组,于入院第1天、3天、7天检测患者血清中IL-1、IL-6、TNF-α水平。结果 :SAP组血清中IL-1、IL-6、TNF-α水平明显高于同期MAP组,差异具有统计学意义(P<0.01)。SAP组第3天比第1天IL-1、IL-6、TNF-α水平略有升高,但差异无统计学意义(P>0.05),第7天IL-1、IL-6、TNF-α水平与同组前两次检测相比较明显下降,差异具有统计学意义(P<0.01),但仍明显高于同期MAP组和对照组。MAP组入院第1天、3天、7天IL-1、IL-6、TNF-α水平逐步下降,差异具有统计学意义(P<0.01),第7天基本恢复正常。与对照组比较无明显差异(P>0.05)。结论:检测AP患者血清中IL-1、IL-6、TNF-α水平有助于评估病情,观测预后。

Objective：To investigate the levels of interleukin-1（IL-1）, interleukin-6 （IL-6） and tumor necrosis fac-tor-α （TNF-α） in serum, and discuss their application for disease observation and prognostic assessment of acute pancre-atitis（AP）. Methods：Fifty eight patients were selected according to the course of disease in 24 hours, who were divided in-to the mild acute pancreatitis（MAP） group（39 cases） and the severe acute pancreatitis （SAP） group （19 cases）. The levels of serum TNF-α, IL-1 and IL-6 were detected at 1, 3 and 7 days of admission. Results：The levels of TNF-α, IL-1 and IL-6 were significantly higher in the SAP group than those in the MAP group （P〈0.01）. In the SAP group,the concentrations of TNF-α, IL-1 and IL-6 rose slightly on 3rd days, but there were no statistical differences （P〉0.05）. However, TNF-α, IL-1 and IL-6 levels on 7th days were significantly decreased and were significanty different from the levels on 1st and 3rd days （P〈0.01）, but still significantly higher than in the MAP group and the controls. For the MAP group, the levels of TNF-α, IL-1 and had IL-6 levels declined gradually and have significant differences compared with the controls （P〈0.01）. On 7th days of admission, the concentrations of TNF-α, IL-1 and IL-6 almost returned to the baseline（P〉0.05）. Conclusions：De-tection of TNF-α, IL-1 and IL-6 levels in serum assists in the disease observation and prognostic assessment of AP.