TNFαIL1βIL6与急性胰腺炎的相关性研究.docVIP

KKME---专业医学搜索引擎/ TNF-α、IL-1β、IL-6与急性胰腺炎的相关性研究 　　作者：裴中美,杨耀娴,张旭璞　　作者单位：1.包头医学院第二附属医院消化科，2.肿瘤科，内蒙古包头 　　【摘要】 目的：观察急性胰腺炎(AP)患者TNF-Α、IL-1Β、IL-6含量的动态变化，探讨其与AP的相关性及临床意义。方法：检测对照组40例及轻症胰腺炎(MAP)组39例、重症胰腺炎(SAP)组23例患者入院后第1、3、7、14天血清中TNF-Α、IL-1Β、IL-6的含量。结果：SAP组血清TNF-Α、IL-1Β、IL-6水平在入院第1、3、7天均高于MAP组及对照组(P0.01)，MAP组在治疗后TNF-Α、IL-1Β、IL-6即下降，第7天下降至接近正常，与对照组比较差异无统计学意义(P0.05)，而SAP组在治疗后第3天TNF-Α、IL-1Β、IL-6仍高于入院第1天(P0.01)，第7天TNF-Α、IL-1Β、IL-6开始下降，但仍高于对照组(P0.01)，至入院后第14天，血清中TNF-Α、IL-1Β、IL-6的含量与对照组比较差异无统计学意义(P0.05)。结论：血清TNF-Α、IL-1Β、IL-6水平可作为早期诊断AP、判断AP发展趋势及防止多器官衰竭的指标，控制炎性介质对降低SAP的死亡率非常重要。 　　【关键词】 急性胰腺炎,白细胞介素,肿瘤坏死因子-Α 　　Abstract Objective: To observe the changes in the content of plasma IL-1Β，IL-6，TNF-Α in the patients with acute pancreatitis(AP) so as to explore their correlation to acute pancreatitis. Methods: The surum level of IL-1Β、IL-6 and TNF-Α was measured in all AP patients(MAP 39, SAP 40)and those from the control group(40)on the 1st, 3rd, 7th and 14th day after admission to the hospital. Results: The levels of IL-1Β、IL-6 and TNF-Α in the serum of SAP on the 1st, 3rd and 7th day were markedly higher than those of MAP and the controls(P〈0.01),and they dropped after the treatment close to the normal on the 7th day in MAP, without significant difference from those in the control group(P 〉0.05). But they were higher on the third day than on the first day in SAP(P0.01). The SAP patients serum levels of IL-1Β、IL-6 and TNF-Α began to decrease on the 7th day, but still higher than those in the control group(P0.01), and were not significantly different from those in the control on the 14th day(P0.05). Conclusion: Serum TNF-Α, IL-1Β, IL-6 levels can be used as the indicators for the early diagnosis of AP, exact trend determination of AP and prevention of multiple-organ failure. To reduce the mortality rate of SAP, it is very important to control inflammatory mediators. 　　Key words Acute pancreatitis; Interleukins; Tumor necrosis factor. 　　急性胰腺炎(AP)是临床常见急腹症之一，其在我国的发病率呈逐年升高趋势[