急性胰腺炎患者血清M30、M65及白细胞介素17水平的变化及意义

Changes in serum levels of M30,M65,and IL-17 and their clinical significance in patients with acute pancreatitis

目的探讨急性胰腺炎(AP)患者血清M30、M65及IL-17水平的变化及临床意义。方法选取2009年12月-2013年12月延安大学附属医院收治的126例AP患者,根据临床诊断分为轻度急性胰腺炎(82例)和急性重症胰腺炎(44例)。选择同期本院体检中心体检的健康人员107例为对照组,分别于第1、2、4天分析3组患者血清中M30、M65、白细胞介素(IL)17水平,以及血清M30/M65值。计量资料多组间比较采用方差分析,进一步两两比较采用SNK-q检验,两组间比较采用独立样本t检验;计数资料组间比较采用χ2检验。结果急性重症胰腺炎及轻度急性胰腺炎患者在第1、2、4天时其血清M30、M65、IL-17水平均显著高于健康受试者(P值均<0.05),而M30/M65比值则显著低于健康受试者(P<0.001);急性重症胰腺炎患者在第1、2、4天时其血清M30、M65水平均显著高于轻度急性胰腺炎患者(P值均<0.001),急性重症胰腺炎患者的M30/M65值则在第1天时显著低于轻度胰腺炎患者(P值均<0.001),但IL-17在轻度急性胰腺炎患者与急性重症胰腺炎患者间差异无统计学意义(P>0.05)。M65和IL-17在诊断AP的过程中具有良好的敏感性及特异性。结论 AP发作后24 h血清M65、IL-17水平和M30/M65值可能成为早期评估AP严重程度的血清生物学标志物。

Objective To investigate the changes in serum levels of M30, M65, and interleukin - 17 （ IL - 17） and their clinical signifi- cance in patients with acute panereatitis. Methods A total of 126 patients with acute pancreatitis who were admitted to our hospital from December 2009 to December 2013 were selected, and according to clinical diagnosis, they were divided into mild acute pancreatitis group （82 patients） and severe acute pancreatitis group （44 patients）. A total of 107 healthy subjects who underwent physical examination during the same period of time were enrolled as the control group. On days 1,2, and 4, the serum levels of M30, M65, and IL - 17 were meas- ured, and M30/M65 ratio was calculated. Comparison of coutinous data between multiple groups was made by ANOVA and pairwise compar- ison between any two groups was made by SNK - q test, comparison between two groups was made by independent - sample t test, while comparison of categorical data by chisquare test. Results On days 1,2, and 4, the severe acute pancreatitis group and mild acute pancrea- titis group had significantly higher serum levels of M30, M65, and IL - 17 （P 〈0.05）, and a significantly lower M30/M65 ratio （P 〈 0. 001 ）, as compared with the healthy controls. On days 1,2, and 4, the severe acute panereatitis group had significantly higher serum lev- els of M30 and M65 than the mild acute pancreatitis group （P 〈0.001 ） ; on day 1, the severe acute pancreatitis group had a significantly lower M30/M65 ratio than the mild acute pancreatitis group （P 〈0.001 ） ; the serum level of IL - 17 showed no significant difference be- tween the two groups （ P 〉0.05 ）. M65 and IL - 17 had high sensitivity and specificity in the diagnosis of acute pancreatitis. Conclusion The serum levels of M65 and IL - 17 and M30/M65 ratio at 24 hours after the attack of acute pancreatitis can be used as the serological bio- markers for early evaluation of the severity of acute pancreatitis.