重症胰腺炎患者血清sICAM-1、IL-6和TNF-α含量的变化及意义

Changes of sICAM-1、IL-6 and TNF-α in Serum of Severe Acute Pancreatitis and Their Significance

【目的】检测急性胰腺炎患者血清可溶性细胞黏附分子1(sICAM-1)、白介素6(IL-6)和肿瘤坏死因子(TNF-α)的水平,探讨其相互关系及判断病情的价值。【方法】185例急性胰腺炎患者分为轻症组(MAP)和重症组(SAP),于入院及治疗d3、d7、d14(SAP组)时采集血清,以ELISA法检测血清sICAM-1、IL-6和TNF-α水平。【结果】SAP组血清sICAM-1I、L-6、TNF-α水平在入院和治疗d3、d7时均显著高于MAP组(P<0.01)。MAP组在治疗d7时下降至接近正常,而SAP组在治疗d7时仍显著高于入院时(P<0.01),d14时下降至接近正常;SAP患者血清sICAM-1与IL-6和TNF-α正相关,r分别为0.62和0.66,P<0.01。【结论】细胞黏附与机体免疫炎症反应有密切关系,血清sICAM-1、TNF-αI、L-6水平与病情的发展相关,有助于早期诊断重症胰腺炎。

[Objective]To investigate the changes of sICAM-1 .IL-6 and TNF-α in serum of acute pancreatitis patients and their significance, and study their roles in diagnosis and therapy of severe acute pancreatitis. [Methods]One hundred eighty five patients of acute pancreatitis were divided into severe acute pancreatitis （SAP） and moderate acute pancreatitis（MAP） group, serum of these cases were collected when hospitalized and at the 3^rd , 7^th 14^th day of treatment, then using EI.ISA to determinate sICAM-1 .IL-6 and TNF-α level in serum, [Resuhs]sICAM-1 ,IL-6 and TNF-α levels of SAP were markedly higher than those of MAP and normal controls when hospitalized and at the 3^rd, 7^th day of treatment; these decreased close to normal after 7 days treatment in MAP, but still kept high in SAP, then decreased markedly after 14 days. sICAM-lshowed direct correlation with IL-6 and TNF-α in cases of SAP. [Conclusion]The levels of sICAM-1 .IL-6 and TNF-α in serum may be served as effective markers in early SAP diagnosis and observing its course of progression.