探讨肿瘤坏死因子a和白细胞介素6在急性胰腺炎诊断及早期严重度评估的价值.docVIP

探讨肿瘤坏死因子-a和白细胞介素-6在急性胰腺炎诊断及早期严重度评估的价值 何晃养(广东省新兴县人民医院急诊科527400) 屮图分类号】R687 】A 】1672-5085 (2012) 30-0223-02 】目的探讨肿瘤坏死因子alpha; (TNF-alpha;)和白细胞介素6 (IL-6) 在急性胰腺炎(AP)患者屮诊断及早期病情严重度评估屮的价值。方法选取81 例AP患者，分为轻症急性胰腺炎(MAP)组57例和重症急性胰腺炎(SAP)组 24例，对SAP组和MAP组在入院后lh、24h、2d、3d、5d抽血测定TNF-alpha; 和IL-6,并对结果进行分析。结果SAP组和MAP组在入院后lh、24h、3d检测 TNF-alpha;和IL-6的水平比较差异有统计学意义(Plt;0.05)。结论血清 TNF-alpha;和IL-6水平变化与AP的发生发展密切相关，可作为AP病情变化和程 度判断的参考指标，对AP早期严重度具有良好的预测作用。 关键词】急性胰腺炎刖1痛坏死因子alpha;白细胞介素6 Discussion Tumor necrosis factor-Alpha and lnterleukin-6 in acute pancreatitis diagnosis and early severity appraisal HehuangYang Peoplersquo;shospital of Xinxing county，Xinxing Guangdong 527400, China [Abstract] Objective:To explore the value dynamic changes of serum levels of tumor necrosis factor-alpha; (TNF-alpha;) and interleukin-6 (IL-6) and to determine their predictive value for severity and prognosis of acute pancreatitis (AP)。 Methods 81 patients with acute pancreatitis were divided into mild acute pancreatitis group (MAP,n=57) and severe acute pancreatitis group (SAP,n=24),SAP and MAP Group at post ndash;admission lh,24h,3d,dedicated TNF-a and IL-6,then analysed and contrasted the results。Results The chang of TNF-a and IL-6 levels at post-admission lh、24h、2d、 3d、5d between SAP and MAP duringhospitalization in patients were statistically significant difference(Plt;0.05)o Conclusion Dynamic changes of the serum levels of TNF-alpha; and IL-6 are related to the occurance and development of acute pancreatitis,and the serum levels of TNF-alpha; and IL-6 on 3rd day may be a predictive index for severity and prognosis of acute pancreatitis. [Key words] Acute pancreatitis Tumor necrosisfactor-alpha; lnterleukin-6 急性勝腺炎(acute pancreatitis AP)是一?种常见急腹症，是胰酶消化胰 腺及其周围组织所引起的急性炎症，是一种以炎性细胞浸润、胰腺水肿、出血及 坏死为特征的胰腺炎性疾病。AP在临床上可分为轻重两种，轻症急性胰腺炎(mild acute pancreatitis, MAP)占胰腺炎发病的80%，20%可进展为S症急性滕腺炎 (severe acute pancreatitis, SAP),不仅累及胰腺，而且影响肝、肺、肾等其他器 官，病死率高达20%?30%。过去30年来AP的发病率逐年升高。轻型易于治 疗，重型病情凶险，病死率高。由于其病因复杂，疾病过程、临床表现及严