急性胰腺炎伴胰腺内分泌功能失调的临床研究

Clinical Study of Endocrine Dysfunction of Islet with Acute Pancreatitis

目的:通过测定急性胰腺炎患者血浆中血糖、C肽(CP)和胰高血糖素(GG)的水平,探讨胰岛内分泌细胞的功能变化。方法:采用电化学发光免疫分析法测定112例急性胰腺炎患者(其中重型急性胰腺炎18例,轻型急性胰腺炎94例)和33例急性胆囊炎患者(对照组)血浆中血糖、CP和GG水平。比较各组患者CP和GG水平的变化,判断胰岛内分泌细胞的功能。结果:重型急性胰腺炎组患者:CP水平于发病后第6天、第10天、第15天明显低于对照组(P<0.05);GG水平于发病后第3天明显高于对照组(P<0.05),第10天、第15天明显低于对照组(P<0.05)。轻型急性胰腺炎组患者:CP的水平与对照组比较差异无统计学意义(P>0.05);GG的水平于发病后第3天、第6天明显高于对照组(P<0.05)。结论:(1)重型急性胰腺炎时胰岛内分泌细胞受到破坏,血浆中CP、GG水平降低;CP能准确、及时地反映胰岛B细胞受损程度。(2)GG水平可以反映胰岛A细胞功能,重型急性胰腺炎时B细胞受损可能比A细胞更早、更重。

Objective： To investigate the levels of blood sugar,C peptide and glucagon in patients with acute panereatitis, to exhibit the function of islet endocrine cells. Methods： The levels of blood sugar, C peptide and glucagon in 112 patients with acute panereatitis and in 33 patients with chronic cholecystitis were tested by electrochemiluminescence immunomassay method. According to the levels of blood sugar, C peptide and glucagon, the function of islet A cells and B cells were tested. Results： The level of C peptide in patients with severe acute pancreatitis was significantly lower than those in patients with acute cholecystitis at 6th, 10th and 15th day after the invasion（P〈0. 05）, the level of glucagon was higher at 3th day and was lower at 10th and 15th day after the invasion（P〈0. 05）. There was no significant difference in C peptide between the patients with mild acute pancreatitis and chronic cholecystitis（P〈0. 05）. The level of glucagon was higher at 3th and 6th day after the invasion（P〈0. 05） Conclusion： The islet endocrine cells were injured in the patients with severe acute pancreatitis, the levels of C peptide and glucagon should be able to exhibit the function of islet B cells and A cells. C peptide might be accurate and punctual to reflect the degree of impaired B cells. The level of glucagons might be able to rflect the function of A cells. The islet B cells might be susceptible to be damaged in severe acute pancreatitis.