急性胰腺炎患者血清TNF-α、IL-6的动态监测及临床价值

Dynamic surveillance and clinical value of tumor necrosis factor-α and interleukin-10 in acute pancreatitis

目的:探讨急性胰腺炎(AP)患者血清肿瘤坏死因子α(TNF-α)、白细胞介素6(IL-6)水平动态变化对病情判断的价值。方法:对32例AP患者分为轻症急性胰腺炎(MAP)组18例和重症急性胰腺炎(SAP)组14例;对照组10例,均为健康志愿者。采用ELISA法检测血清TNF-α和IL-6水平。结果:(1)入院第1天两组患者血清TNF-α水平较对照组明显升高(P<0.05);随后MAP组逐渐下降,第7天降至正常;SAP组血清TNF-α水平则持续升高,第3天达峰值;第3、7、14天SAP组明显高于MAP组(P<0.05)。(2)入院第1天两组患者血清IL-6水平与对照组比较无差异(P>0.05);入院第3天两组血清IL-6水平均显著升高并达峰值,并分别于第7和14天降至正常;第3、7天血清IL-6水平SAP组明显高于MAP组(P<0.05)。结论:血清TNF-α和IL-6水平变化与AP的发生发展密切相关,入院第3天两者的水平可作为AP病情程度判断的参考指标。

Objective：To explore the dynamic changes of serum levels of tumor necrosis factor-α （INF-α） and interleukin-6（IL-6） and to determine their predictive value for severity and prognosis of acute pancreatitis（AP）. Methods：32 patients with acute pancreatitis were divided into mild acute pancreatitis group（MAP, n=lS） and severe acute pancreatitis group （SAP,n=14）; 10 healthy volunteers were employed as the control group. The serum levels of INF-α and IL-6 in 32 AP and 10 healthy volunteers were tested by ELISA. Results： （1）The serum levels of INF-α in the two AP groups were significantly higher than those in the control group on day 1 of admission （P〈0.05,respectively）;then the level of INF-α in MAP group decreased gradually and to the nomal level on day 7;the level of INF-α in SAP group increased continuously and to the top level on day 3; the levels of INF-α in SAP group were obviously higher than those in MAP group on day 3,7 andl4 respectively （P〈0.05,respectively）. （2）There were no difference of the levels of IL-6 between the AP groups and the control group on day 1 （P〉0.05, respectively）; the level of IL-6 in the two AP groups increased obviously and to the top levels on day 3 and decreased to the normal level on day 7,14 respectively; the levels of IL-6 in the SAP group were obviously higher than those in MAP group on day 3 and 7 respectively （P〈0.05,respectively）. Conclusion：Dynamic changes of the serum levels of INF-α and IL-6 are related to the occurance and development of acute pancreatitis; the serum levels of INF-α and IL-6 on day 3 may be a predictive index for severity and prognosis of acute pancreatitis.