血清炎性细胞因子测定评价急性胰腺炎严重程度的临床价值

Clinical Value of Exploring the Severity in Patients with Acute Pancreatitis Through Determining Serum Cytokines Levels

目的:探讨急性胰腺炎(acute pancreatitis,AP)患者测定血清炎性因子水平评价病情严重程度的临床价值。方法:采用放射免疫分析和超敏酶免疫分析测定了165例AP患者[其中80例重型AP(severe AP,SAP)及85例中轻型AP(mild AP,MAP)]的血清肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)、白介素-6(in-terleukin-6,IL-6)、白介素-8(interleukin-8,IL-8)和高敏C-反应蛋白(high-sensitive C-reactive protein,hs-CRP)水平并与60例正常对照组进行比较分析。结果:在炎性细胞因子的分析中,165例AP患者的血清TNF-α、IL-6、IL-8和hs-CRP水平分别为(3.71±1.02)ng/ml、(6.59±2.02)pg/ml、(80.64±23.40)ng/ml和(7.71±1.02)mg/L,较之60例正常对照组分别为(1.03±0.32)ng/ml、(2.41±0.67)pg/ml、(24.28±9.01)ng/ml、(2.26±0.48)mg/L非常明显增高(P均<0.01)。80例SAP患者血清TNF-α、IL-6、IL-8和hs-CRP水平较之85例MAP患者明显增高(P分别为<0.05、<0.01、<0.01和<0.05),从而表明,血清炎性细胞因子水平随AP严重程度而增加。结论:血清炎性细胞因子(TNF-α、IL-6、IL-8和hs-CRP)水平是评价AP患者严重程度非常有价值的指标,以便选择正确的治疗方案,提高治愈率。

Objective In order to study the clinical value of exploring the severity in patients with acute pancreatitis through determining serum cytokines levels. Methods The levels of serum TNF-α （with RIA）, IL-6, IL-8 and hs-CRP （with high-sensitive EIA） were analyzed in 165 patients with AP （including 80 cases SAP and 85 cases MAP） and 60 normal controls as well as comparative analysis. Results In the cytokines analysis, the levels of serum TNF-α,IL-6,IL-8 and hs-CRP in 165 patients with AP were 3.71 ± 1.02ng/ml,6.59 ± 2.02pg/ml, 80.64 ±23.40ng/ml and 7.71 ± 1.02mg/L respectively, and were significantly higher than those in 60 normal controls （ i. e. 1.03±0.32ng/ml,2.41 ±0. 67pg/ml,24.28 ＋9.01ng/ml and 2.26 ±0. 48mg/L individually,P all 〈 0.01 ）. The levels of serum TNF-α, IL-6, IL-8 and hs-CRP in 80 patients with SAP were significantly higher than those in 85 patients with MAP （P 〈 0.05, 〈 0.01, 〈 0.01 and 〈 0.05 respectively）. The experiment indicated that serum cytokines levels were increased with AP severity. Conclusion Serum cytokines （for example TNF-α,IL-6,IL-8 and hs-CRP） levels were a valuable index for exploring in patients with AP severity, so the choice of correct treatment plan and could be raise the curable rate.