CAJ | 학술논문

目的：探讨重症急性胰腺炎（SAP）患者早期免疫功能的变化趋势及临床意义。方法采用酶联免疫吸附测定（ELISA）法检测42例SAP患者不同时间血浆C反应蛋白（CRP）、IgG、IgM、IgA、C3、C4、肿瘤坏死因子α（TNF-α）及白细胞介素-10（IL-10）；采用流式细胞仪检测其血浆CD3＋、CD4＋和CD8＋ T淋巴细胞亚群的分布情况。结果 SAP患者血浆CRP水平具有先升后降的趋势，而血浆IgG和IgM水平的变化趋势呈 V 字形，差异有统计学意义（P＜0．05）。血浆CD4＋ T 淋巴细胞数及CD4＋/CD8＋比值逐渐增高（P＜0．05），但CD8＋ T淋巴细胞数在观察期间变化的差异无统计学意义（P＞0．05）。血浆TNF-α水平先升后降，而IL-10的水平逐步升高（P＜0．05），IL-10/TNF-α比值缓慢升高（P＜0．05）。结论 SAP患者炎症反应强度呈先升后降趋势，这有助于治疗措施的制定。
목적：탐토중증급성이선염（SAP）환자조기면역공능적변화추세급림상의의。방법채용매련면역흡부측정（ELISA）법검측42례SAP환자불동시간혈장C반응단백（CRP）、IgG、IgM、IgA、C3、C4、종류배사인자α（TNF-α）급백세포개소-10（IL-10）；채용류식세포의검측기혈장CD3＋、CD4＋화CD8＋ T림파세포아군적분포정황。결과 SAP환자혈장CRP수평구유선승후강적추세，이혈장IgG화IgM수평적변화추세정 V 자형，차이유통계학의의（P＜0．05）。혈장CD4＋ T 림파세포수급CD4＋/CD8＋비치축점증고（P＜0．05），단CD8＋ T림파세포수재관찰기간변화적차이무통계학의의（P＞0．05）。혈장TNF-α수평선승후강，이IL-10적수평축보승고（P＜0．05），IL-10/TNF-α비치완만승고（P＜0．05）。결론 SAP환자염증반응강도정선승후강추세，저유조우치료조시적제정。
Objective To investigate the trends of immune function changes of patients with severe acute pancreatitis (SAP) in early stage and their clinical significance .Methods Enzyme-linked immunosorbent assay(ELISA) was employed to detect the plas-ma C-reactive protein(CRP) ,IgG ,IgM ,IgA ,C3 ,C4 ,tumor necrosis factor alpha(TNF-α) and interleukin-10(IL-10) of 42 patients with SAP at different times .Flow cytometry was used to assay the plasma distribution of CD3+ ,CD4+ and CD8+ T lymphocyte subsets .Results Plasma CRP levels in patients with SAP showed trend of first rising and then decreasing ,while the change trends of plasma IgG and IgM were V-shaped ,with statistical difference(P<0 .05) .The number of plasma CD4+ T lymphocyte and ratio of CD4+ /CD8+ were gradually increased(P<0 .05) ,however ,the difference of CD8+ T lymphocyte changes during the observation period showed no significant (P> 0 .05) .Levels of plasma TNF-α were found first increasing and then decreasing ,IL-10 levels , gradually increasing(P<0 .05) ,and ratios of IL-10/TNF-α,slowly increasing(P<0 .05) .Conclusion Inflammation intensity of pa-tients with SAP shows a trend of first increasing and then decreasing ,which contribute to the development of therapeutic measures .