急性胰腺炎急性期全身炎症反应综合征和血清细胞因子变化的意义-普外科专业论文.docxVIP

急性胰腺炎急性期全身炎症反应综合征和血清细胞因子变化的意义 急性胰腺炎急性期全身炎症反应综合征和血清细胞因子变化的意义 摘要 摘要 目的：研究急性胰腺炎(acute pancreatitis，AP)急性期全身炎症反 应综合征(systemic inflammatory response syndrome，SIRS)发生、持续 时间和严重程度对AP的影响。探讨细胞因子在AP病程发展中的作 用。 方法：研究对象为2000--2002年确诊为AP的86例住院患者。 正常对照组：取30例正常健康自愿者作为对照组。男15例，女15 例。分别计算SIRS在轻症急性胰腺炎(mild acute pancreatitis，MAP) 和重症急性胰腺炎(severe acute pancreatitis，SAP)中的发生率并相互 比较。按病程中是否发生SIRS分为SIRS组与非SIRS组，分别比较 SIRS发生、持续时间、严重程度对AP的影响。应用放免法ELISA 法检测AP患者血液中TNF．Ⅱ、IL．1 B、IL。6、IL．8，对SAP患者， 每隔l天进行血液中TNF—Q、IL．1 B、IL一6、IL一8检测，比较AP病 程演进中细胞因子的变化。 结果：重症胰腺炎的SIRS发生率高于轻型胰腺炎(P0．01)，且随 SIRS程度的加重，AP患者病死率升高(P0．05)。MAP、SAP患者血 液中TNF．a、IL．6、IL。8含量与正常对照组相比明显增高(P0．05、 P0．01)，并与临床症状的严重程度一致。 结论：AP患者SIRS发生、SIRS持续时间和SIRS严重程度与预 后有密切关系；细胞因子参与了AP的病理发展过程，并且是组织损 伤的重要因素。 关键词：急性胰腺炎；全身炎症反应综合征(SIRS)； 细胞因子 作 者：夏菁 指导老师：钱海鑫教授 管惟苓教授 丁一民教授 急性胰腺炎急性期争身炎症反应综合征和血清细胞因子变化的意义 急性胰腺炎急性期争身炎症反应综合征和血清细胞因子变化的意义 ABSTRACT Significance on Systemic Inflammatory Response Syndrome and Changes of Serum Cytokines in Acute Phase of Acute Pancreatitis ABSTRACT objective：To study the onset，duration and severity of systemic inflammatory response syndrome(SIRS)in early stage of acute pancreatitis(AP)．and to explore the role of cytokines in the progression of acute pancreatitis． Methods：86 patients were diagnosed as acute pancreatitis in our hospital from 2000 to 2002，and 30 healthy volunteers(1 5 male and 1 5 female)as control group．The morbidity of SIRS in mild acute pancreatitis(MAP)and in severe acute pancreatitis(SAP)was calculated and compared with each other．Based on the presence or absence of SIRS in the course，the AP patients were grouped as non—SIRS and SIRS to study the onset．duration and severity of SIRS in AP．Plasma TNF—Q， IL．1 B．IL．6 and IL．8 were determined by ELISA in AP patients．TNF- Q．IL一1 D，IL。6 and IL．8 were determined on alternative days in SAP patients to study the role of cytokines in the progression of acute pancreatitis． Results：The morbidity of SIRS in SAP was higher than that in the mild group of AP(P0．0 1)．The m