急性胆源性胰腺炎患者的早期腺泡损伤与炎症因子反应的临床研究

Clinical study of earlyacinar injury and inflammatory factor response in patients with acute biliary pancreatitis

[目的]探讨急性胆源性胰腺炎(acute biliary pancreatitis ,ABP)患者发病早期的血清炎症因子水平与胰腺腺泡损伤程度的相关性。[方法]收集2013-01-2015-12期间在本院接受治疗的56例ABP患者,其中轻度ABP患者25例、中度ABP患者18例、重度ABP患者13例。并选取30例健康体检人群为健康对照,比较不同程度分级的ABP患者血清IL-6水平与健康对照者的差异。通过病理切片染色评估ABP患者的胰腺腺泡损伤占所有胰腺组织的比例,并比较与胰腺炎的严重程度、血清IL-6水平的相关性。[结果]ABP患者的血清IL-6水平[(44. 8±13. l)pg/m口显著高于健康对照者[(3. 6±0. 4)pg/ml,P<0. 01];并且ABP患者的血清II.-6水平随ABP程度加重而升高,差异有统计学意义(P<0. 01). ABP患者的腺泡损伤比例中位数为0.37(0. 14~0.73),胰腺腺泡损伤比例随ABP程度加重而显著增加(P<0.01),并且重度腺泡损伤患者比例随ABP程度加重而显著增加(P<0.01)。通过Pearson相关系数和线性回归方程发现血清IL-6水平与ABP患者的胰腺腺泡损伤比例呈显著正相关关系(R=0. 730,P<0.01)o [结论]血清IL-6水平的升高能够早期反映ABP患者的胰腺腺泡损伤程度。

[Objective]To investigate the association between the serum inflammatory cytokines and the extent of pancreatic acinar injury in patients with acute biliary pancreatitis( ABP).[Methods] We enrolled 56 patients with ABP who were treated in our hospital from January 2013 to December 2015?in which 25 patients were diagnosed with mild ABP, 18 patients were diagnosed with moderate ABP, and 13 patients were diagnosed with severe ABP. Another 30 healthy cases were selected as the control group to compare the serum IL-6 levels with ABP patients. And the serum IL-6 levels were also compared between different subgroups of ABP patients. The pathological section staining was used to assess the proportion of pancreatic acinar injury to total pancreatic tissues,and compared the severity with pancreatitis and serum IL-6 lev-els.[ Results]Serum levels of IL-6 in patients with ABP([44. 8 ±13. 1 ]pg/ml) were significantly higher than those in healthy controls([3. 6±0. 4]pg/mLP<0.01 ).and serum levels of IL-6 in patients with ABP increased aggravation, with the statistically significant difference(P<0.01). The median proportion of acinar injury in patients with ABP was 0. 37(0. 14 .0. 73),and the proportion of pancreatic acinar injury increased significantly with the severity of AEP(P<0.01) 9 and the percentage of patients with severe acinar injury increased significantly with the severity of ABP(PV0. 01). Pearson correlation coefficient and linear regression showed a significant positive correlation between serum IL-6 level and pancreatic acinar injury rate in ABP patients(R= 0.730,P<0.01).[Conclusion]The elevation of serum IL-6 level can early predict the extent of pancreatic acinar injury in patients with ABP.