内镜治疗急性梗阻性化脓性胆管炎对Caspase3活性、PMN凋亡及呼吸爆发的影响

The influence of endoscopic treatment of patients with acute obstructive suppurative cholangitis on caspase-3 activity, apoptosis and respiratory burst of neutrophil in peripheral blood

目的研究内镜治疗急性梗阻性化脓性胆管炎（AOSC）对外周血caspase3活性、中性粒细胞（PMN）凋亡率及呼吸爆发的影响。方法检测并比较50名正常健康人，90例AOSC内镜治疗组及38例手术治疗组患者在治疗前、后外周血caspase3活性，PMN凋亡率、呼吸爆发及住院时间变化。结果AOSC患者治疗前与正常对照者比较：外周血caspase3活性、PMN凋亡率及呼吸爆发差异均有统计学意义（P〈0．01）。在治疗后第5天，内镜治疗组及手术治疗纽外周血caspase3活性，PMN凋亡率及呼吸爆发均较治疗前明显改善（P〈0．01），且内镜治疗组基本恢复正常（P〉0．05），住院时间明显短于手术治疗组（P〈0．01）。结论AOSC患者外用血存在caspase3活性降低、PMN凋亡延迟及呼吸爆发增强，内镜治疗AOSC能较快提高外周血caspase3活性，促进PMN凋亡及减轻呼吸爆发，减少患者住院时间。

Objective To investigate the influence of endoscopic treatment of patients with acute obstructive suppurative cholangitis （AOSC） on activity of caspase 3, apoptosis rate of neutrophil and respiratory burst in peripheral blood. Method 50 healthy subjects, 90 AOSC patients treated with endoscopic treatment and 38 AOSC patients treated with surgery were included in this study. Activity of caspase3, apoptosis rate of neutroghil and respiratory burst in peripheral blood were measured and compared before and after treatment, and the average length of hospital stay was evaluated. Result Activity of caspase 3, apoptosis rate of neutroghil and respiratory burst in peripheral blood in patients with AOSC before treatment were significantly different from healthy subjects（ P 〈 0. 01 ）. The activity of easpase 3, apoptosis rate of neutrophil and respiratory burst were improved more significantly in peripheral blood of after endoscopic and surgery treatment of 5 days than those before treatment （ P 〈 0. 01 ）. And those after endoscopic treatment recovered normally （ P 〉 0. 05 ）. The average length of hospital stay in endoscopic treatment group was shorter than that in surgery treatment group （ P 〈 0. 01 ）. Conclusion There was decrease in activity of caspase 3, block of neutrophil apoptosis of neutrophil and enhancement of respiratory burst in peripheral blood with AOSC patients. Endoscopic treatment of patients with AOSC was associated with enhancing activity of easpase 3, promoting apoptosis of neutroghil and lowering respiratory bust in peripheral blood, and it could shorten the hospital stay.