急性胰腺炎患者外周血IL-6、HGF、Ang-2变化的初步研究

Dynamic Changes of Peripheral Blood IL-6,HGF and Ang-2 in Patients with Acute Pancreatitis

背景:免疫细胞过度激活-炎症因子学说是急性胰腺炎(AP)最重要的发病机制之一,大量炎症因子释放可导致全身性炎症反应综合征,因此探索用于判断AP病情严重程度的血清细胞因子指标具有重要临床意义。目的:监测AP患者入院后1周内外周血白细胞介素-6(IL-6)、肝细胞生长因子(HGF)和血管生成素-2(Ang-2)的动态变化,初步探讨这些指标在AP中的临床意义。方法:收集2014年4月-10月苏州大学附属第一医院收治的AP患者72例,按照2012年亚特兰大分类分为轻度(MAP)(n=54)、中度(MSAP)(n=12)和重度AP(SAP)(n=6)组,同期30名健康人作为对照组。以ELISA法检测入院第1、3、7天血清IL-6、HGF、Ang-2水平。结果:入院后1周内,AP患者血清IL-6、HGF、Ang-2水平均显著高于对照组(P<0.05);MAP组3个指标均呈逐渐下降趋势;MSAP组IL-6呈逐渐上升趋势,Ang-2呈逐渐下降趋势,HGF升至峰值后下降;SAP组IL-6升至峰值后下降,HGF、Ang-2下降后再次上升。MSAP、SAP组各时点3个指标均高于MAP组,MSAP与SAP组间差异无统计学意义(P>0.05)。结论:IL-6、HGF、Ang-2可能在AP发病机制中起重要作用,可作为判断AP严重程度和病情变化的血清学指标。

Background： Excessive immune cell activation-inflammatory factor theory is one of the most important pathogenic mechanisms of acute pancreatitis（ AP）. As the release of inflammatory factors is associated with systemic inflammatory response syndrome,seeking of serum cytokine markers for severity assessment of AP is of great clinical importance. Aims：To determine the dynamic changes of interleukin-6（ IL-6）,hepatocyte growth factor（ HGF）,and angiopoietin-2（ Ang-2）in peripheral blood of AP patients in the first week after admission,and investigate preliminarily the clinical significance of these markers in AP. Methods： Seventy-two AP patients were prospectively recruited from Apr. 2014 to Oct. 2014 at the First Affiliated Hospital of Soochow University and were assigned into three groups： mild AP（ MAP,n = 54）,moderately severe AP（ MSAP,n = 12） and severe AP（ SAP,n = 6） according to the Atlanta classification of AP-2012. Thirty healthy subjects were served as controls. Serum levels of IL-6,HGF and Ang-2 were determined by ELISA on the 1st,3rd and 7th day after admission. Results： In the first week after admission,serum levels of IL-6,HGF and Ang-2 were significantly higher in AP patients than in controls（ P〈0. 05）. In MAP group,all three markers were gradually decreased in the first week; while in MSAP group,IL-6 was gradually increased,Ang-2 was gradually decreased,and HGF decreased after reaching the peak; in SAP group,IL-6 decreased after reaching the peak and HGF and Ang-2 increased again after a decrease. Serum levels of IL-6,HGF and Ang-2 were higher in MSAP group and SAP group than in MAP group at all the time points,but no statistically significant differences were observed between MSAP group and SAP group（ P〈0. 05）.Conclusions： IL-6,HGF and Ang-2 might play important roles in the pathogenesis of AP,and being the promising serum markers for severity assessment and dynamic monitoring of AP.