C-反应蛋白及白细胞介素6早期预测急性胰腺炎合并感染的实验研究

Experimental study of C-reactive protein and interleukin-6 as early predictors of acute pancreatitis associated with infection

目的研究C-反应蛋白(CRP)及白细胞介素6(IL-6)对急性胰腺炎并感染的诊断价值。方法60只SD大鼠随机分为急性胰腺炎组(AP组,n=40)及假手术组(S组,n=20),分别检测成模前(0h)及成模后12,24及48h时血浆CRP及IL-6水平和48h时腹水细菌培养。结果(1)AP组存活36例,均制模成功。16例发生腹水感染(AP1组),而20例未见腹水感染(AP2组)。(2)AP1及AP2组血浆CRP及IL-6水平在成模后均显著高于S组(P均<0.01)。AP1与AP2组比较,仅CRP在48h时有显著升高(P<0.01)。(3)AP1组在成模后IL-6及CRP逐渐上升,各时点均存在显著的差异(P均<0.05);而AP2组IL-6及CRP仅在成模后24h内显著升高(P均<0.05),而术后48h和24h时差异并无显著性(P>0.05)。结论血浆CRP对急性胰腺炎早期发生感染诊断具预测价值,而IL-6则对急性胰腺炎并继发的细菌感染并不敏感。

ObjectiveTo study the value of C-reactive protein (CRP) and interleukin-6(IL-6) in the (diagnosis) of acute pancreatitis (AP) associated with infection. MethodsSixty SD rats were randomly (assigned) into group AP (n=40) and sham-operation group (S, n=20). Plasma CRP and IL-6 were detected before AP(0h), and at 12h, 24h and 48h after AP. Serum amylase detection and ascitic bacteria culture were carried out at 48h. Results(1)In AP group, 36 rats were alive. Ascitic infection developed in 16 cases (group AP1), and not in the other 20 cases (group AP2). (2)Plasma CRP and IL-6 levels in group AP1 and AP2 were significantly higher than those in group S (all, P<0.01). In group AP1, compared to group AP2, except the CRP concentrations at 48h had a significant increase(P<0.01), at all the other time periods, no significant differences of plasma IL-6 and CRP concentrations were observed (all, P>0.05). (3)In group AP1, IL-6 and CRP elevated significantly at all time periods after the model setup (P<0.05). But in group AP2, elevation of IL-6 and CRP was only observed at 12h(both, P<0.05), and there was no significant difference between 24h and 48h (P>0.05). (Conclusions)Plasma CRP has predictive value in the diagnosis of early infection in acute pancreatitis, but plasma IL-6 is not sensitive to secondary bacteria infection in acute pancreatitis.