奥曲肽对重症急性胰腺炎患者血清炎性细胞因子的影响_临床医学论文.docVIP

奥曲肽对重症急性胰腺炎患者血清炎性细胞因子的影响_临床医学论文 奥曲肽对重症急性胰腺炎患者血清炎性细胞因子的影响_临床医学论文 【摘要】 目的 研究奥曲肽对重症急性胰腺炎(severe acute pancreatitis，SAP)患者血清白细胞介素-6(interleukin 6，IL-6)、白细胞介素-8(interleukin 8，IL-8)及肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)等细胞因子的影响。方法 48例SAP患者随机分成丹参治疗组及非丹参治疗组，每组24例；选择年龄匹配的20例健康志愿者为对照组。在患者入院24 h内以及治疗4、7 d后采静脉血并检测血清中IL-6、IL-8和TNF-α水平。结果 SAP患者3种炎症因子较健康志愿者均显著升高(0．05)。奥曲肽治疗组与非奥曲肽治疗组入院时3种细胞因子差异无统计学意义(Pgt;0．05)，治疗4、7 d后两组SAP患者3种细胞因子均降低(0．05)，但奥曲肽治疗组下降更明显(0．05)。结论 奥曲肽可降低SAP患者的炎症性细胞因子。 　　【关键词】 奥曲肽；重症胰腺炎；白细胞介素-6；白细胞介素-8；肿瘤坏死因子-α 　　 　　【Abstract】 ObjectiveTo study the effects of octreotide on serum levels of cytokines including interleukin-6（IL-6),interleukin-8 (IL-8) and tumor necrosis factor alpha (TNF-α) in patients with severe acute pancreatitis(SAP)．Methods Forty eight SAP patients were randomly divided into octreotide-treated group and non-octreotide treated group with twenty four patients in each group． Twenty age-matched healthy volunteers were assigned to control group． Serum levels of IL-6， IL-8 and TNF-α were tested within 24 hours of admission 4 days and 7 days after admission．Results Compared with those of the healthy volunteers, serum levels of the IL-6, IL-8 and TNF-α of the SAP patients were significantly elevated (0．01)． Serum levels of the three cytokines were significantly decreased in both octreotide-treated group and non- octreotide-treated group after 7-day treatment(0．05)．The declining of the serum levels of the three cytokines in octreotide-treated group was more obvious than that in non-octreotide treated group．Conclusion Octreotide can treat SAP patients by reducing the serum levels of IL-6,IL-8,and TNF-α． 　　【Key words】Octreotide；Severe acute pancreatitis；Interleukin-6；Interleukin-8；Tumor necrosis factor alpha 　　重症急性胰腺炎(SAP)是临床上常见的消化系统急性重症，临床经过凶险，严重者伴有休克、呼吸衰竭及肾脏衰竭，病死率高达15%～30%，其发病机制至今尚未完全明了。近年来随着研究的深入，细胞因子和炎症反应失衡理论的重要性已得到公认，细胞因子水平可用于判断AP的病情及预后。本文探讨SAP患者细胞因子IL-6、IL-8、TNF-α水平的变化，以及采用奥曲肽治疗对这些变化所产生的影响，现报道如下。　　1 资料与方法　　1．1 一般资料 2004年12月至2007年12月间本院住院治疗的SAP患者48例，其中