CAJ | 학술논문

目的研究早期急性重症胰腺炎(SAP)患者肠黏膜屏障功能障碍与机体免疫应答的相关性.方法对2010年1月至2012年12月入选本研究的46例SAP患者,在入选后第1天、第3天、第7天和第14天测定其内毒素水平、尿液中乳果糖与甘露醇之比(L/M)、D(-)-乳酸盐含量、Th1/Th2比、HLA-DR和CD4+ CD25+ Treg细胞百分比.结果早期SAP(最初的14 d内)患者的内毒素含量、L/M之比、D(-)-乳酸盐浓度、HLA-DR百分比均有所降低,而调节性CD4+ CD25+ Treg细胞频率有所增强.在第1周,Th1/Th2之比随Th1的降低、Th2的增加而降低,但后期它会随着Th1的增加而增加.结论早期SAP患者存在的免疫抑制及免疫失衡与肠黏膜屏障失功能呈正相关.重视早期保护肠黏膜屏障是有效治疗SAP的重要因素.
목적 연구조기급성중증이선염(SAP)환자장점막병장공능장애여궤체면역응답적상관성.방법 대2010년1월지2012년12월입선본연구적46례SAP환자,재입선후제1천、제3천、제7천화제14천측정기내독소수평、뇨액중유과당여감로순지비(L/M)、D(-)-유산염함량、Th1/Th2비、HLA-DR화CD4+ CD25+ Treg세포백분비.결과 조기SAP(최초적14 d내)환자적내독소함량、L/M지비、D(-)-유산염농도、HLA-DR백분비균유소강저,이조절성CD4+ CD25+ Treg세포빈솔유소증강.재제1주,Th1/Th2지비수Th1적강저、Th2적증가이강저,단후기타회수착Th1적증가이증가.결론 조기SAP환자존재적면역억제급면역실형여장점막병장실공능정정상관.중시조기보호장점막병장시유효치료SAP적중요인소.
Objective To explore the relationship between gut mucosal barrier dysfunction and immune response in patients with early severe acute pancreatitis (SAP).Method 46 patients with early SAP were enrolled into this study from January 2010 to December 2012.Results The levels of endotoxin,the lactulose/mannitol (L/M) ratio,the D (-)-lactate concentration,and the proportion of HLA-DR-positive monocytes all decreased from a high level,while the frequency of Tregs increased during the first 14 days.The Th1/Th2 ratio decreased,with a decreased Th1 and an increased Th2 profile in the first week,but it subsequently increased,with an increased Th1 profile.Conclusions The data from this study showed that immunosuppression and immune imbalance happened in patients with early SAP,and showed a positive relationship with gut mucosal barrier dysfunction in patients with early SAP.Thus,early protection of the function of intestinal mucosal barrier is important in the treatment of SAP.