急性胰腺炎患者血清可溶性Tim-3、炎症因子及RAAS分子检测的临床意义

Clinical significance of serum soluble Tim-3,inflammatory factors and RAAS-related molecules in patients with acute pancreatitis

目的探讨不同病情急性胰腺炎(AP)患者血清可溶性Tim-3(s-Tim-3)、炎症因子及RAAS分子检测的临床意义。方法选取2016年1月—2019年1月内江市第二人民医院收治的AP患者90例,按APACHEⅡ系统评分分为轻度AP组和中重度AP组。另取同期该院健康体检者50例作为对照组。测定所有研究对象血清s-Tim-3、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)、群体反应性抗体(PRA)、血管紧张素Ⅱ受体(AngⅡ)及醛固酮(ALD)水平,采用Pearson法分析血清s-Tim-3水平、APACHEⅡ系统评分、RAAS分子及炎症因子间的相关性。结果中重度AP组血清IL-6、TNF-α表达水平较轻度AP组高(P<0.05),IL-10水平较轻度AP组低(P<0.05),轻度AP组血清较对照组高(P<0.05),对照组较中重度AP组低(P<0.05)。中重度AP组PRA、AngⅡ及ALD表达水平较轻度AP组高(P<0.05),轻度AP组较对照组高(P<0.05),对照组较中重度AP组低(P<0.05)。中重度AP组血清s-Tim-3表达水平较对照组高(P<0.05),轻度AP组较对照组高(P<0.05),对照组较中重度AP组低(P<0.05),中重度AP组较轻度AP组高(P<0.05)。Pearson相关性分析显示,AP患者血清IL-6、TNF-α、PRA、AngⅡ、ALD及s-Tim-3水平与APACHEⅡ评分呈正相关(r=0.671、0.502、0.521、0.633、0.521和0.753,均P<0.05),IL-10与APACHEⅡ评分呈负相关(r=-0.567,P<0.05);AP患者血清IL-6、TNF-α、PRA、AngⅡ及ALD与s-Tim-3水平呈正相关(r=0.642、0.512、0.521、0.623和0.535,均P<0.05),IL-10与s-Tim-3水平呈负相关(r=-0.532,P<0.05)。结论AP患者血清s-Tim-3、炎症因子及RAAS分子与病情有关,且s-Tim-3与炎症因子、RAAS分子也存在相关性,检测上述指标有助于临床上AP患者病情严重程度的评估及早期治疗。

Objective To investigate the clinical significance of serum soluble T-cell immunoglobulin and mucin domain-3(s-Tim-3),inflammatory factors and molecules related to renin-angiotensin-aldosterone system(RAAS)in patients with acute pancreatitis(AP)of different conditions.Methods A total of 90 patients with AP who were admitted to our hospital from January 2016 to January 2019 were enrolled.According to APACHE II score,the patients were divided into mild AP group(MAP group,n=59)and moderate to severe AP group(MSAP group,n=31).Another 50 subjects who underwent a physical examination in our hospital at the same time were selected as healthy control group.Serum s-Tim-3,interleukin-6(IL-6),interleukin-10(IL-10),tumor necrosis factor-α(TNF-α),panel reactive antibody(PRA),angiotensin II receptor(Ang II)and aldosterone(ALD)levels were measured in all subjects.Pearson correlation was used to analyze the correlation among serum s-Tim-3 levels,APACHE II scores,RAAS-related molecules,and inflammatory factors.Results The serum IL-6,TNF-α,PRA,Ang II,ALD levels in MSAP group were higher than those in MAP group(P<0.05),whereas the serum IL-10 level in MSAP group was lower than that in MAP group(P<0.05).The serum IL-6,IL-10,TNF-α,PRA,Ang II and ALD levels in the MAP group were higher than those in the healthy control group(P<0.05).The serum level of s-Tim-3 was higher in the MSAP group than that in the other groups,while that in the MAP group was greater than that in the healthy control group(P<0.05).Pearson correlation analysis showed that serum levels of IL-6,TNF-α,PRA,Ang II,ALD,s-Tim-3 were positively correlated with APACHE II scores in AP patients(r=0.671,0.502,0.521,0.633,0.521,0.753;all P<0.05).Serum IL-10 level was negatively correlated with APACHE II score in AP patients(r=-0.567,P<0.05).Serum s-Tim-3 level in AP patients was positively correlated with IL-6,TNF-α,PRA,Ang II and ALD levels(r=0.642,0.512,0.521,0.623,0.535;all P<0.05),and was negatively correlated with IL-10 level(r=-0.532,P<0.05).Conclusions Serum s-Tim-3,inflammatory factors and RAAS-related molecules in AP patients are related to the disease condition,and s-Tim-3 has a correlation with inflammatory factors and RAAS-related molecules.Thus,detection of the above indicators is helpful to assess the severity of AP patients and conducive to early treatment.