急性胰腺炎患者血清PCT、IL-6和hs-CRP水平变化的临床意义

Clinical significance of serum levels of PCT, IL-6, hs-CRP in patients with acute pancreatitis

目的观察急性胰腺炎患者血清降钙素原(Procalcitonin,PCT)、白细胞介素-6(Interleukin-6,IL-6)和超敏C反应蛋白(high sensitivity C-reactive protein,hs-CRP)在病程中的变化,探讨PCT、IL-6及hs-CRP在急性胰腺炎诊治中的临床意义。方法轻症急性胰腺炎(MAP)患者50例,重症急性胰腺炎(SAP)患者20例,动态检测入院后第1、4和7天血清PCT、IL-6及hs-CRP的水平,并与30例正常健康人对照组进行比较。结果急性胰腺炎患者各个检测时间点PCT、IL-6及hs-CRP结果均显著高于对照组(P<0.05)。其中PCT在SAP组和MAP组入院后第4天出现峰值。MAP组7 d左右逐渐恢复至接近正常高限水平,SAP组则下降不明显;IL-6在入院后第4天出现峰值,随后逐渐降低,第7天时MAP组就恢复到接近正常水平,而SAP组仍维持在较高水平,两组间差异有显著性(P<0.05);hs-CRP两组均在入院后第1天达到峰值,随后逐渐降低,余各检测时间点结果与第1天比较差异均有显著性(P<0.05)。第4天后MAP组恢复到正常水平附近,而SAP组仍维持较高水平,两组间比较差异有显著性(P<0.05)。结论血清PCT、IL-6和hs-CRP指标联合动态检测对AP的诊断、治疗、严重程度分级、病情发展及预后评估具有重要临床价值,并对探讨AP患者发病机制具有一定意义。

【Objective】To explore the dynamic changes and clinical value of the serum procalcitonin（PCT）, interleukin-6（IL-6） and high-sensitivity C-reactive protein（hs-CRP） during the early process of acute pancreatitis. 【Methods】70 patients were divided into two groups, mild acute pancreatitis（n =50） and severe acute pancreatitis（n =20）. All patients were employed for measuring the serum levels of PCT, IL-6 and hs-CRP in patients on days 1, 4, 7 of onset of acute pancreatitis, 30 cases of health volunteers were enrolled as control group. 【Results】PCT, IL-6 and hs-CRP levels in patients with acute pancreatitis were significantly higher than those in control group. The levels of PCT reached the peak in day 4 for both groups, and it slightly decreased in day 7 for SAP group, meanwhile, itwas almost down to normal high value in day 7 for MAP group respectively. The levels of IL-6 of two groups reached the peak in day 4. The peak serum level of hs-CRP in both SAP and MAP groups occurred on day 1, and gradually decreased after the treatment（P ＆lt;0.05）. Hs-CRP level decreased to normal value in day 4 for MAP group, and it maintained high value in day 4 for SAP group（P ＆lt;0.05）.【Conclusion】The changes of serum PCT, IL-6 and hs-CRP levels manifest positive correlationswiththe severity of the condition of the patients with acute pancreatitis,and it can be more informative in evaluating the changes of the conditions in early acute pancreatitis.