血清IL-6、IL-8、IL-10、IL-22水平与急性胰腺炎严重程度的相关性研究

Correlation of serum levels of IL-6,IL-8,IL-10,and IL-22 with severity of acute pancreatitis

目的探讨血清白细胞介素-6、8、10、22(IL-6、IL-8、IL-10、IL-22)水平在急性胰腺炎(AP)早期诊断中的价值。方法选择近3年滕州市中医院收治的123例轻度急性胰腺炎(MAP组)、37例中度和28例重度急性胰腺炎(MSAP+SAP组)患者以及30例健康体检者(对照组)作为研究对象。MAP组患者中男性70例,女性53例,年龄(43.7±13.7)岁;MSAP+SAP组患者中男性45例,女性20例,年龄(45.0±13.3)岁;对照组,其中男性17例,女性13例,年龄(45.3±11.8)岁。入院第1、3、7、10天采用酶联免疫吸附试验(ELISA)检测患者血清IL-6、IL-8、IL-10、IL-22水平,并比较分析其在急性胰腺炎早期诊断和病情严重程度判断中的价值。结果MSAP+SAP组第1天血清IL-6、IL-8、IL-22分别为(277.60±46.72)pg/ml、(99.84±18.66)pg/ml、(175.77±26.66)pg/ml,第3天分别为(231.47±57.72)pg/ml、(77.89±30.33)pg/ml、(140.97±44.31)pg/ml,第7天分别为(207.97±76.93)pg/ml、(68.59±38.11)pg/ml、(125.77±54.06)pg/ml,第10天分别为(187.21±89.94)pg/ml、(59.75±45.19)pg/ml、(111.44±61.54)pg/ml;MAP组第1天血清IL-6、IL-8、IL-22分别为(199.51±28.86)pg/ml、(97.36±19.05)pg/ml、(122.67±18.10)pg/ml,第3天分别为(148.30±30.94)pg/ml、(70.68±8.64)pg/ml、(94.00±13.53)pg/ml,第7天分别为(125.92±22.58)pg/ml、(52.04±6.82)pg/ml、(80.60±11.59)pg/ml,第10天分别为(97.36±19.05)pg/ml、(44.89±9.08)pg/ml、(59.46±17.28)pg/ml;两组比较差异均有统计学意义(均P<0.05)。MAP组患者入院时血清IL-10水平升高,随后逐渐降低,第10天降至正常水平;MSAP+SAP组患者入院时血清IL-10水平略低于对照组,随后逐渐降低,差异均有统计学意义(均P<0.05)。AP患者血清IL-6、IL-8、IL-22水平与急性生理功能和慢性健康状况评分系统Ⅱ(APACHEⅡ)评分均呈正相关,血清IL-10水平与APACHEⅡ评分呈负相关。ROC分析发现,血清IL-22水平对SAP的早期诊断效能最大(AUC=0.948),灵敏度及特异度分别为0.938和0.813。结论血清IL-6、IL-8、IL-10、IL-22有助于急性胰腺炎的早期诊断,且与病情严重程度密切相关。

Objective To investigate the value of interleukin-6,-8,-10,and-22(IL-6,IL-8,IL-10,and IL-22)in the early diagnosis of acute pancreatitis(AP).Methods One hundred and twenty-three patients with mild acute pancreatitis(MAP),37 patients with moderately severe acute pancreatitis(MSAP),28 patients with severe acute pancreatitis(SAP),and 30 heathy examinees(a control group)were selected as the study objects.There were 70 males and 53 females in the MAP group,they were(43.7±13.7)years old.There were 45 males and 20 females in the MSAP+SAP group,they were(45.0±13.3)years old.There were 17 males and 13 females in the control group,they were(45.3±11.8)years old.The serum levels of IL-6,IL-8,IL-10,and IL-22 in were measured by enzyme linked immunosorbent assay on day 1,3,7,and 10 after admission;and their value in the early diagnosis and in the evaluation of severity of AP were analyzed.Results The serum levels of IL-6,IL-8,and IL-22 in the MSAP+SAP group were(277.60±46.72)pg/ml,(99.84±18.66)pg/ml,and(175.77±26.66)pg/ml on day 1,were(231.47±57.72)pg/ml,(77.89±30.33)pg/ml,and(140.97±44.31)pg/ml on day 3,were(207.97±76.93)pg/ml,(68.59±38.11)pg/ml,and(125.77±54.06)pg/ml on day 7,and were(187.21±89.94)pg/ml,(59.75±45.19)pg/ml,and(111.44±61.54)pg/ml on day 10;the serum levels of IL-6,IL-8,and IL-22 in the MAP group were(199.51±28.86)pg/ml,(97.36±19.05)pg/ml,and(122.67±18.10)pg/ml on day 1,were(148.30±30.94)pg/ml,(70.68±8.64)pg/ml,and(94.00±13.53)pg/ml on day 3,were(125.92±22.58)pg/ml,(52.04±6.82)pg/ml,and(80.60±11.59)pg/ml on day 7,and were(97.36±19.05)pg/ml,(44.89±9.08)pg/ml,and(59.46±17.28)pg/ml on day 10;there were statistical differences between these two groups(all P<0.05).The serum IL-10 level in the MAP group at admission was increased,and decreased gradually to a normal level on day 10;the serum level in the MSAP+SAP group at admission was slightly lower than that in the control group,and decreased gradually after adimission,but with no statistical difference(all P<0.05).The serum levels of IL-6,IL-8,and IL-22 in the AP patients were correlated with their APACHEⅡscores,and the serum level of IL-10 negatively.ROC analysis found that serum IL-22 level had the highest diagnostic efficacy for SAP(AUC=0.948),and its sensitivity and specificity were 0.938 and 0.813.Conclusion The serum levels of IL-6,IL-8,IL-10,and IL-22 are helpful in the early diagnosis of AP and are related to AP severity.