CAJ | 학술논문

目的探讨血清肝细胞生长因子(HGF)、表皮生长因子(EGF)、碱性成纤维生长因子(bFGF)、再生蛋白(Reg)-1、Reg-4的水平变化对急性胰腺炎(AP)恢复期胰腺内、外分泌功能的影响及机制.方法根据2007年中国AP诊治指南草案对25例轻症AP恢复期和34例重症AP恢复期患者进行随访研究.同时选取20名健康志愿者作对照.应用酶联免疫吸附法检测血清HGF、EGF、bFGF、Reg-1、Reg-4表达水平,同时检测空腹血糖、胰岛素、C肽及粪弹力蛋白酶(FE)1水平,评估胰腺内、外分泌功能.统计分析胰腺功能与发病时临床指标的相关性以及这些再生相关因子与胰腺功能的相关性.结果患者组FE1水平[(205.9±18.3)μg/g]较正常对照组[(333.9±19.7)μg/g]显著下降(P<0.01),空腹血糖、胰岛素及C肽水平则显著升高(P<0.01).轻、重症胰腺炎组恢复期胰腺内、外分泌功能差异无统计学意义(P值均>0.05).轻症与重症胰腺炎组HGF、EGF、bFGF、Reg-1、Reg-4表达水平差异无统计学意义(P值均>0.05).AP恢复期重度和轻、中度外分泌功能受损者血清HGF表达水平[分别为(983.76±372.65)和(946.80±254.47)pg/ml]高于外分泌功能正常者[(263.44±110.35)pg/ml,P值均<0.05].AP恢复期糖尿病患者EGF表达水平[(704.41±190.37)pg/ml]高于血糖正常者[(360.03±48.39)pg/ml,P<0.05].血清HGF水平与FE1水平负相关(r=-0.331,P<0.01).AP恢复期是否发生糖耐量异常或糖尿病与急性发病时的CT分级相关(P<0.05).结论患者在AP恢复期存在明显胰腺内、外分泌功能不全.血清EGF、HGF表达水平可能分别与AP恢复期内、外分泌功能修复有关.
목적 탐토혈청간세포생장인자(HGF)、표피생장인자(EGF)、감성성섬유생장인자(bFGF)、재생단백(Reg)-1、Reg-4적수평변화대급성이선염(AP)회복기이선내、외분비공능적영향급궤제.방법 근거2007년중국AP진치지남초안대25례경증AP회복기화34례중증AP회복기환자진행수방연구.동시선취20명건강지원자작대조.응용매련면역흡부법검측혈청HGF、EGF、bFGF、Reg-1、Reg-4표체수평,동시검측공복혈당、이도소、C태급분탄력단백매(FE)1수평,평고이선내、외분비공능.통계분석이선공능여발병시림상지표적상관성이급저사재생상관인자여이선공능적상관성.결과 환자조FE1수평[(205.9±18.3)μg/g]교정상대조조[(333.9±19.7)μg/g]현저하강(P<0.01),공복혈당、이도소급C태수평칙현저승고(P<0.01).경、중증이선염조회복기이선내、외분비공능차이무통계학의의(P치균>0.05).경증여중증이선염조HGF、EGF、bFGF、Reg-1、Reg-4표체수평차이무통계학의의(P치균>0.05).AP회복기중도화경、중도외분비공능수손자혈청HGF표체수평[분별위(983.76±372.65)화(946.80±254.47)pg/ml]고우외분비공능정상자[(263.44±110.35)pg/ml,P치균<0.05].AP회복기당뇨병환자EGF표체수평[(704.41±190.37)pg/ml]고우혈당정상자[(360.03±48.39)pg/ml,P<0.05].혈청HGF수평여FE1수평부상관(r=-0.331,P<0.01).AP회복기시부발생당내량이상혹당뇨병여급성발병시적CT분급상관(P<0.05).결론 환자재AP회복기존재명현이선내、외분비공능불전.혈청EGF、HGF표체수평가능분별여AP회복기내、외분비공능수복유관.
Objective To investigate the effect of cytokines on pancreatic function in patients after acute pancreatitis(AP) and its mechanisms. Methods Fifty-nine patients (mild in 25 and severe in 34) after AP and 20 healthy controls were enrolled in the study. Serum levels of cytokines including hepatocyte growth factor (HGF), epidermal growth factor(EGF), basic fibroblast growth factor (bFGF), regeneration protein(Reg)-1 and Reg-4 were determined using enzyme-linked immunosorbent assay (ELISA). Fasting blood-glucose, insulin, C-peptide and fecal elastase 1 (FE1) were detected for evluation of endocrine and exocrine pancreatic function. The association of pancreatic function with clinical parameters and serum cytokines was analyzed. Results The expression of FE1 was lower in patients [(205.9±18.3) μg/g] after AP in comparison with the controls [(333.9±19.7) μg/g, P<0. 01], but levels of fasting blood-glucose, C-peptide and insulin were higher in patients group (P<0.01). Serum level of HGF was higher in patients with insufficient pancreatic exoerine [(983.76±372.65) pg/ml] than those with normal exocrine function [(263.44±110. 35) pg/ml]. Meanwhile,EGF level was higher in patients with DM after AP [(704.41±190. 37) pg/ml] than those without DM [(360. 03±48.39) pg/mh P<0.05]. There was a negatively correlation between FE1 and HGF (P ＜0. 01). The abnormal fasting blood glucose was correlated with CT grading (P<0. 05).Conclusions The patients after AP develope insufficient exocrine and endocrine function. Serum EGF and HGF may be associated with restoration of pancreatic endocrine and exocrine function.