急性胰腺炎患者外周血内毒素核心抗体及TNF-α水平与病情严重度的关系

The relationship between the serum level of endotoxin core antibody, TNF-α and the severity of acute pancreatitis.

目的探讨内毒素核心抗体水平及TNF-α水平与AP病情严重度之间的关系。方法应用ELISA方法测定30例AP患者（SAP15例,MAP15例）入院第1天、第7天与第14天的外周血内毒素核心抗体和TNF-α水平,并以20例健康自愿者作为对照。结果MAP患者和SAP患者在入院第1天的外周血内毒素核心抗体水平都明显低于对照组（P〈0.01）。SAP患者第1天的外周血内毒素核心抗体水平明显低于MAP患者（P〈0.01）,但第7、第14天的水平却高于同期MAP患者（P〈0.01）。伴有脏器功能损害的SAPⅡ级患者在第1天的内毒素核心抗体水平也较没有脏器损害的SAPⅠ级患者低,但在第7、第14天的内毒素核心抗体水平则高于SAPⅠ级患者（P〈0.01）。MAP与SAP患者在入院第1、7、14天的外周血TNF-α水平均高于正常对照组（P〈0.01）,SAP患者的水平高于MAP患者,SAPⅡ级患者又高于SAPⅠ级患者。结论早期测定内毒素核心抗体和TNF-α水平可能是评估胰腺炎严重程度的有价值指标。

Objective To investigate the correlation between the serum level of endotoxin core antibody, TNF-α and the severity of acute pancreatitis. Methods Peripheral blood level of endotoxin core antibody and TNF-α in 30 patients with acute pancreatitis in our unit on their admission 1, 7, 14 days and 20 healthy controls were determined by using ELISA. Results Peripheral blood level of endotoxin core antibody in patients with MAP or SAP were significantly lower than that in control group （P 〈 0.01）, and the level in SAP group at admission day 1 was significantly lower than that in MAP group（P〈0.01）, but the level in SAP group at admission 7, 14 days were significantly higher than those in MAP group （P 〈 0.01）. Peripheral blood level of endotoxin core antibody in SAP （Level Ⅱ ） patients with organ dysfunction was significantly lower than SAP （Level Ⅰ） patients without organ dysfunction in admission day （P 〈 0.01 ）, but was higher in admission 7, 14 days （P 〈 0.01）. Peripheral blood level of TNF-α in patients with MAP or SAP were significantly higher than that in control group （P 〈 0.01）. The level in SAP group was significantly higher than that in MAP group in admission 1, 7, 14 days respectively（P 〈 0. 01）, and the level in SAP （Level Ⅱ ） group with organ dysfuction was significantly higher than SAP （Level Ⅰ） patients without organ dysfunction in admission 1, 7, 14 days respectively. Conclusions Early measurement of endotoxin core antibody and TNF-α of AP patients may be useful to predict the severity and prognosis.