NF-κB、IL-33及sST2在急性胰腺炎合并急性肾损伤中的价值研究

Role of NF-κB,IL-33 and sST2 in acute renal injury following acute pancreatitis

目的:探讨NF-κB、IL-33、sST2在急性胰腺炎(AP)合并急性肾损伤(AKI)患者中的价值。方法:AP患者67例分为轻度(MAP)、中重度(MSAP)、重度(SAP)3组,所有AP患者又分为AKI组和非AKI组。健康志愿者25例。采用流式细胞术检测外周血中NF-κB激活,酶联免疫吸附法测定血清IL-33、sST2水平。结果:MAP组NF-κB p65 24h即有显著激活为(30.72±9.25)%;MSAP组NF-κB p65激活2～3d达到高峰,为(78.48±10.94)%;SAP组NF-κB p65激活变化趋势与MSAP组基本一致,但在AP发病早期NF-κB p65激活更加明显(P <0.05)。对照组各时段NF-κB p65激活不明显(P>0.05)。AKI组血清中IL-33水平为(278.3±23.4)pg/mL,非AKI组为(137.5±18.5)pg/mL,均较对照组明显升高,差异有统计学意义(P <0.01)。sST2水平在AKI组和非AKI组也有类似结果。结论:AP合并AKI患者早期外周血中即有NF-κB明显激活,IL-33和sST2高表达。

Objective： To study the role of nuclear factor-kappa B （NF-κB） activation, IL-33and sST2 in acute renal injury （AKI） following acute pancreatitis （AP） patients. Method： 67 cases ofAP patients were divided into the mild acute pancreatitis （MAP）group, the moderately severe acutepancreatitis（MSAP） group and the severe acute pancreatitis（SAP） group, and all AP patients were dividedinto the AKI group and the non-AKI group. NF-κB activation was surveyed by flow cytometryin AP patients and the control.Application of enzyme-linked immunosorbent assay （ELISA） for detectingIL-33 and sST2 in serum. Results： We found that the expression of NF-κB activation[（30.72±9.25）%] in MAP group was significantly increased in 24h. In MSAP group, the peak of theexpression of NF-κB activation was（78.48±10.94）%during 2~3d. The change trend of NF-κBactivationin SAP group was basically consistent with MSAP group, surprisingly, NF-κBactivation atearly stage more obviously （ 〈0.05）. No significant difference was found at different time points incontrol group. The expression level of IL-33 in serum of AKI group [（278.3 ＋23.4） pg/ml] was higherthan that[（137.5＋18.5） pg/mL] in non-AKI group（ 〈0.01）, and the similar changes of the average levelof sST2 in AKI and non-AKI group. Conclusion： The expression of NF-κB activation,IL-33 andsST2 were significantly higher at early stage in AKI following AP patients peripheral blood. And IL-33and sST2 could be used as early potential biomarkers of AKI following AP.