内镜治疗急性梗阻性胆道感染对患者血清白介素2和白介素6及C反应蛋白影响的临床研究

Clinical Research on the Influence of IL-2,IL-6 and CRP Through Endoscopic Therapy for Patients with Acute Obstruction Biliary Infection

目的探讨经内镜治疗急性梗阻性胆道感染对患者血清白介素2(IL-2)、IL-6和C反应蛋白(CRP)的影响。方法选取2009—2010年在我院进行治疗的60例急性梗阻性胆道感染患者为治疗组,采用内镜下行Oddi括约肌切开术及鼻胆管引流治疗,治疗7 d,选取同期我院健康体检正常者60例为对照组。双抗体夹心酶联免疫吸附试验(ELISA)法测定治疗前后血清IL-2、IL-6。血清CRP采用自动免疫散射速率法检测。比较两组IL-2、IL-6和CRP有无差异。并将IL-2、IL-6和CRP进行相关分析。结果经内镜下行Oddi括约肌切开术及鼻胆管引流治疗后患者血清IL-2(32.3±7.4)ng/L、IL-6(35.5±13.5)ng/L和CRP(11.4±8.6)mg/L,与治疗前血清IL-2(153.2±37.3)ng/L、IL-6(223.2±63.3)ng/L和CRP(91.4±22.3)mg/L比较,差异均有统计学意义(P<0.05)。采用Spearman秩相关分析,患者血清IL-2与IL-6水平呈正相关(rs=0.327,P=0.024);患者血清IL-2与CRP水平呈正相关(rs=0.217,P=0.013);患者血清IL-6与CRP水平呈正相关(rs=0.717,P=0.002)。结论内镜治疗急性梗阻性胆道感染的机制与调节患者血清IL-2、IL-6和CRP的水平有关。IL-6对急性梗阻性胆道感染的患者病情判断具有重要意义。

Objective To investigate the influence of endoscopic treatment on serum interleukin（IL-2）,interleukin（IL-6） and C-reactive protein（CRP） in patients with acute obstructive biliary infections.Methods 60 patients with acute obstructive biliary infection treated in our hospital from 2009 to 2010 were selected as treatment group,which was given endoscopic downside Oddi sphincter dissection and bile duct drainage treatment for 7 d.60 healthy people in the same period were selected as the control group.The levels of serum IL-2 and IL-6 were tested by double antibody sandwich ELISA method.The serum level of CRP was tested by automatic immune scattering rate method.The levels of serum IL-2,IL-6 and CRP were compared and analyzed.Results The levels of serum IL-2,IL-6 and CRP were（32.3±7.4）ng/L,（35.5±13.5）ng/L and（11.4±8.6）mg/L respectively after endoscopic downside Oddi sphincter dissection and the bile duct drainage treatment.Compared with the（153.2±37.3）ng/L,（223.2±63.3）ng/L and（91.4±22.3）mg/L before treatment,the differences were statistically significant（P0.05）.Spearman rank correlation analysis showed that the level of serum IL-2 was positively correlated with the level of serum IL-6（rs=0.327,P=0.024）.The level of serum IL-2 was positively correlated with the level of serum CRP（rs=0.217,P=0.013）.And the level of serum IL-6 was also positively correlated with the level of serum CRP（rs=0.717,P=0.002）.Conclusion The mechanism of treating acute obstructive biliary infection is concerned with the adjustment of patient′s serum IL-2,IL-6 and CRP levels.IL-6 is the main factor to judge the stage of acute obstructive biliary infection patients.