急性胰腺炎恢复期患者血清再生相关细胞因子水平及其与胰腺功能的关系

Level of Serum Cytokines Related with Regeneration and its Relationship with Pancreas Function in Recovery Patients with Acute Pancreatitis

目的:探讨急性胰腺炎(AP)恢复期患者血清肝细胞生长因子(HGF)、表皮生长因子(EGF)、成纤维细胞生长因子-2(FGF-2)、再生蛋白-I(Reg-I)等再生相关细胞因子水平及其与胰腺功能的关系。方法:选取AP恢复期患者130例,其中轻症AP组56例、重症AP组74例。另选取健康体检合格者60例,设为对照组。检测所有受试对象的血清HGF、EGF、FGF-2、Reg-I及粪弹力蛋白酶-1(FE-1),以及空腹血糖(FBG)、胰岛素及C肽水平。对血清再生相关细胞因子与胰腺内外分泌功能进行相关性分析。结果:轻症AP组、重症AP组血清FBG、胰岛素、C肽以及HGF、EGF、FGF-2、Reg-I水平均高于对照组,粪FE-1低于对照组(P<0.05或P<0.01);重症AP组血清FBG、胰岛素、C肽以及HGF、EGF高于轻症AP组,粪FE-1低于轻症AP组(P<0.05)。胰腺外分泌功能轻中度受损组、重度受损组血清HGF、EGF、FGF-2、Reg-I水平均高于正常范围组(P<0.05或P<0.01)。重度受损组患者的血清HGF、EGF均高于轻中度受损组(P<0.05)。糖耐量异常组、糖尿病组血清HGF、EGF、FGF-2、Reg-I水平均高于正常血糖组。糖尿病组血清HGF、EGF均高于糖耐量异常组(P<0.05)。AP恢复期患者血清HGF、EGF均与FE-l水平呈负相关,均与空腹胰岛素水平呈正相关(P<0.01)。结论:急性胰腺炎恢复期患者血清HGF、EGF、FGF-2、Reg-I等再生相关细胞因子水平较高,血清HGF、EGF与FE-l水平呈负相关,与空腹胰岛素水平呈正相关,可能通过与相应的受体结合而激活细胞信号转导机制,促进胰腺细胞及间质成分的再生与积聚,最终发挥胰腺修复与再生的作用。

Objective： To investigate the correlation between the level of regeneration serum cytokines（hepatocyte growth factor（HGF）, epidermal growth factor（EGF）, fibroblast growth factor-2（FGF-2）, Regeneration protein-I（Reg-I）, etc） and pancreas function in recovery patients with acute pancreatitis（AP）. Methods： 130 cases with AP in recovery stage were devided into the mild AP group（56 cases） and the severe AP group（74 cases）,60 healthy volunteers were selected as control group. All researched cases＇ serum HGF, EGF,FGF-2, Reg-I and fecal elastase-1（FE-1）, also fasting blood glucose（FBG）, insulin and C-peptide were tested, and the correlation between serum cytokines related with regeneration and pancreas＇ endocrine and exocrine function were analyzed. Results： Serum FBG,insulin, C-peptide, and HGF, EGF, FGF-2, Reg-I in mild AP group and severe AP group were all higher than those in control group, yet FE-1 was lower than control group（P〈0.05 or P〈0.01）. Serum FBG, insulin, C-peptide, and HGF, EGF in severe AP group were all higher than those in mild AP group, and FE-1 was lower than mild AP group（P〈0.05）. Serum HGF, EGF, FGF-2, Reg-I in mild to moderate impairment group and severe impairment group of pancreas＇ exocrine function were all higher than those in control group（P〈0.05 or P〈0.01）. Serum HGF, EGF in severe impairment group were all higher than those in mild to moderate impairment group（P〈0.05）.Serum HGF, EGF, FGF-2, Reg-I in impaired glucose tolerance group and diabetes mellitus group were all higher than those in normal blood glucose group. Serum HGF, EGF in diabetes mellitus group were higher than those in impaired glucose tolerance group（P〈0.05）. Serum HGF and EGF had negative correlation with FE-l in recovery AP patients, and had positive correlation with fasting insulin（P〈0.01）. Conclusion： Level of serum cytokines related with regeneration is high in recovery AP patients, including HGF, EGF,FGF-2, Reg-I, etc. Serum HGF and EGF has negative correlation with FE-l, and haspositive correlation with fasting insulin, and the cytokines may activate signal transduction mechanism by combination with corresponding receptors, further promote regeneration and accumulation of pancreatic cells and mesenchyme, finally play pancreatic repair and regeneration.