急性胰腺炎血清炎性细胞因子的临床分析

Clinical analysis of inflammatory cytokines in acute pancreatic patients

目的探讨急性胰腺炎血清各炎性细胞因子的表达水平及变化情况。方法收集急性胰腺炎102例,其中轻症急性胰腺炎68例,重症急性胰腺炎34例,另收集80例健康体检者为对照组,ELISA测定各血清炎性细胞因子水平,同时进行白细胞及淋巴细胞计数。结果急性胰腺炎患者白细胞计数、IL-1b、IL-6、IL-8、IL-10、IL-12、巨噬细胞移动抑制因子(MIF)血清水平显著高于正常人组,淋巴细胞计数、IL-4显著低于正常人。轻症急性胰腺炎患者白细胞计数、IL-6、IL-8、MIF和IL-10血清水平显著低于重症急性胰腺炎组,淋巴细胞计数显著高于重症急性胰腺炎组。IL-6诊断重症急性胰腺炎灵敏度为79.2%,特异性为75.0%,MIF的灵敏度为79.2%,特异性为69.0%。IL-6诊断死亡急性胰腺炎灵敏度为71.4%,特异性为97.3%,MIF的灵敏度为100%,特异性为62.7%。结论重症急性胰腺炎表现为典型的全身炎症反应综合征,IL-6和MIF可作为预测急性胰腺炎病情的指标。

【Objective】 To analyze the serum levels of inflammatory cytokines and changes of the acute pancreatitis.【Methods】102 cases of acute pancreatitis,including 68 cases of mild acute pancreatitis and 34 cases of severe acute pancreatitis,80 cases of health people as control group,the serum levels of inflammatory cytokines,leukocyte and lymphocyte counts were detected.【Results】 Acute pancreatitis patients with white blood cell count,IL-1b,IL-6,IL-8,IL-10,IL-12,macrophage migration inhibitory factor（MIF） serum levels were significantly higher than the normal group,lymphocyte count,IL-4 was significantly lower than the normal.Mild acute pancreatitis patients white blood cell count,IL-6,IL-8,MIF,IL-10 serum levels were significantly lower than the severe acute pancreatitis patients,lymphocyte counts were significantly higher than the severe acute pancreatitis patients.The sensitivity and specificity for the prediction of severe acute pancreatitis were 79.2%,75.0% for IL-6,79.2%,69.0% for MIF respectively.The sensitivity and specificity for the prediction of death acute pancreatitis were 71.4%,97.3% for IL-6,100%,62.7% for MIF.【Conclusion】 Severe acute pancreatitis performed a typical systemic inflammatory response syndrome,and IL-6,MIF can be used as a predictor of acute pancreatitis.