吲哚美辛栓对ERCP术后血清淀粉酶、炎症因子和免疫功能的影响

Effects of indomethacin suppositories on serum amylase,inflammatory factors and immune function after endoscopic retrograde cholangiopancreatography(ERCP

目的:探讨吲哚美辛栓对内镜逆行胰胆管造影(ERCP)术后血清淀粉酶、炎症因子和免疫功能的影响。方法:将85例需行ERCP治疗的胆总管结石或梗阻性黄疸患者按照治疗方法不同分为观察组(n=45)和对照组(n=40),两组均进行ERCP治疗,观察组于术前30 min给予吲哚美辛栓50 mg肛塞。检测术前、术后6h以及术后24h血清淀粉酶,炎症因子:白细胞介素-6(IL-6)、白细胞介素-10(IL-10)、肿瘤坏死因子-α(TNF-α)以及白细胞介素-4(IL-4),T细胞亚群:CD3^+、CD4^+、CD8^+,计算CD4^+/CD8^+。结果:两组术后6、24h血清淀粉酶均较术前显著升高,且观察组术后6、24h血清淀粉酶显著低于对照组相同时间点,差异均有统计学意义(P<0.05)。两组术后6、24h血清促炎因子IL-6、TNF-α先升高后降低,且显著高于术前;两组术后6、24h血清抗炎因子IL-10、IL-4逐渐升高,且显著高于术前,差异均有统计学意义(P<0.05);观察组与对照组术后6、24h相同时间点比较发现,观察组抗炎因子IL-10、IL-4显著升高,促炎因子IL-6、TNF-α显著降低,两组间比较具有统计学差异(P<0.05)。两组术后6、24hT细胞亚群CD3^+、CD4^+、CD4^+/CD8^+先降低后升高,且显著低于术前,差异有统计学意义(P<0.05);观察组术后6、24hCD3^+、CD4^+、CD4^+/CD8^+显著高于对照组相同时间点,差异有统计学意义(P<0.05)。结论:吲哚美辛栓可以降低ERCP术后血清淀粉酶,减轻炎症反应,调节免疫功能。

Objective：To explore the effects of Indomethacin Suppositories on serum amylase, inflammatory factors and immune function after endoscopic retrograde cholangiopancreatography （ERCP）. Methods.. A total of 85 cases patients with common bile duct stones or obstructive jaundice were divided into the observation group （n =45） and the control group （n = 40） according to the different treatment methods both two groups patients were treated with ERCP, patients in the observa- tion group was given indomethacin suppositories 50 mg preoperative 30 min. Serum amylase, inflammatory factors and T cellsubsets were detected preoperative, postoperative 6 h and postoperative 24 h. Inflammatory factors including interleukin-10 （IL-10）, interleukin-6 （IL-6）, tumor necrosis factor alpha （TNF-α） and interleukin-4 （IL-4）. T cell subsets including CD3＋ , CD4＋ , CD8＋ and calculated CD4＋/CD8＋ . Results： both two groups postoperative 6h, 24 h serum amylase were signiFicantly higher than before surgery; in the observation group, the postoperative 6 h, 24 h serum amylase were significantly lower than in the control group at the same time point （P〈0.05）. Both two groups postoperative 6 h, 24 h serum pro--inflammatory fac- tor IL-6 and TNF-α increased first and then decreased, both were significantly higher than before surgery; both two groups postoperative 6 h, 24 h serum anti--inflammatory factor IL-10 and IL-4 gradually increased, both were significantly higher than before surgery （P〈0.05） ; in the observation group, anti-inflammatory factor IL-10 and IL-4 significantly increased while pro--inflammatory factor IL-6 and TNF-α significantly decreased compared with the control group at the same time point 6 h and 24 h after surgery （P〈0.05）. Both two groups postoperative 6 h, 24 h T cell subsets CD3＋ , CD4＋ , CD44 /CD8＋ first decreased and then increased, all were significantly lower than before surgery （P〈0.05） ; in the observation group, the post- operative 6 h, 24 h CD3＋ , CD4＋ , CD4＋/CD8＋ were significantly higher than in the control group at the same time point （P 〈0.05）. Conclusions.. Indometacin suppositories could lower the postoperative serum amylase, reduce inflammation reaction and regulate immune function.