CAJ | 학술논문

目的：通过检测急性胰腺炎（A P ）患者血清中白细胞介素‐1（IL‐1）、白细胞介素‐6（IL‐6）及肿瘤坏死因子‐α（T N F‐α）水平，探讨其在病情观察和预后评估中的作用。方法选取2010年1月至2013年1月灌云人民医院住院治疗的AP患者（发病时间小于24 h）58例，分为轻症急性胰腺炎（MAP）组39例，重症急性胰腺炎（SAP）组19例，于入院第1、3、7天，检测血清IL‐1、IL‐6及T N F‐α水平；同时另选取本院体检中心体检合格的健康人31例为健康对照组，检测血清IL‐1、IL‐6及 TNF‐α水平。动态检测患者急性生理和慢性健康评估（APACHEⅡ）评分和CT严重度指数（CTSI），进行比较分析。结果 SAP组患者血清IL‐1、IL‐6及 TNF‐α水平明显高于同期MAP组，差异具有统计学意义（P＜0．01）；SAP组患者第3天比第1天IL‐1、IL‐6及TNF‐α水平略高，但差异无统计学意义（P＞0．05），第7天 IL‐1、IL‐6及 TNF‐α水平明显下降，与同组前两次检测相比较，差异具有统计学意义（P＜0．01）。MAP组患者入院第1、3、7天IL‐1、IL‐6及TNF‐α水平逐渐下降，差异具有统计学意义（P＜0．01），第7天基本恢复正常，与健康对照组比较差异无统计学意义（P＞0．05）。SAP组患者APACHEⅡ评分及CTSI明显高于MAP组，差异有统计学意义（P＜0．01）；且入院第3天MAP与SAP组患者血清IL‐1、IL‐6及 TNF‐α水平与A‐PACHEⅡ评分及CTSI均呈正相关（P＜0．01）。结论检测AP患者血清中IL‐1、IL‐6及 TNF‐α水平有助于评估患者的病情和预后，值得临床推广。
목적：통과검측급성이선염（A P ）환자혈청중백세포개소‐1（IL‐1）、백세포개소‐6（IL‐6）급종류배사인자‐α（T N F‐α）수평，탐토기재병정관찰화예후평고중적작용。방법선취2010년1월지2013년1월관운인민의원주원치료적AP환자（발병시간소우24 h）58례，분위경증급성이선염（MAP）조39례，중증급성이선염（SAP）조19례，우입원제1、3、7천，검측혈청IL‐1、IL‐6급T N F‐α수평；동시령선취본원체검중심체검합격적건강인31례위건강대조조，검측혈청IL‐1、IL‐6급 TNF‐α수평。동태검측환자급성생리화만성건강평고（APACHEⅡ）평분화CT엄중도지수（CTSI），진행비교분석。결과 SAP조환자혈청IL‐1、IL‐6급 TNF‐α수평명현고우동기MAP조，차이구유통계학의의（P＜0．01）；SAP조환자제3천비제1천IL‐1、IL‐6급TNF‐α수평략고，단차이무통계학의의（P＞0．05），제7천 IL‐1、IL‐6급 TNF‐α수평명현하강，여동조전량차검측상비교，차이구유통계학의의（P＜0．01）。MAP조환자입원제1、3、7천IL‐1、IL‐6급TNF‐α수평축점하강，차이구유통계학의의（P＜0．01），제7천기본회복정상，여건강대조조비교차이무통계학의의（P＞0．05）。SAP조환자APACHEⅡ평분급CTSI명현고우MAP조，차이유통계학의의（P＜0．01）；차입원제3천MAP여SAP조환자혈청IL‐1、IL‐6급 TNF‐α수평여A‐PACHEⅡ평분급CTSI균정정상관（P＜0．01）。결론검측AP환자혈청중IL‐1、IL‐6급 TNF‐α수평유조우평고환자적병정화예후，치득림상추엄。
Objective To investigate the serum levels of interleukin‐1 (IL‐1) ,interleukin‐6 (IL‐6) and tumor necrosis factor‐α (TNF‐α) in patients with acute pancreatitis (AP) ,and to explore the role of cytokines for the as‐sessment of disease severity and prognosis. Methods During Jan. 2010 and Jan. 2013 ,58 AP patients ,with onset time of AP within 24 h ,were enrolled and divided into mild AP (MAP) group (39 cases) and severe AP (SAP) group (19 cases). Serum levels of TNF‐α,IL‐1 and IL‐6 were detected at 1 ,3 and 7 days after admission. The correlation of cy‐tokines with the acute physiology and chronic health evaluation (APACHEⅡ) score and CT severity index (CTSI) were also analyzed. Results Serum levels of TNF‐α,IL‐1 and IL‐6 were significantly higher in SAP group than those in MAP group (P<0. 01). In SAP group ,the concentrations of TNF‐α,IL‐1 and IL‐6 increased slightly in 3 days , though there were no statistical differences (P> 0. 05). However ,serum levels of TNF‐α,IL‐1 and IL‐6 at 7 days were significantly decreased ,compared with the corresponding levels at 1 and 3 days (P<0. 01). However ,these de‐clined serum levels of selected cytokines were still significantly higher than MAP group. In MAP group ,serum levels of TNF‐α,IL‐1 and IL‐6 decreased gradually and reached significant differences when compared with controls (P<0. 01). At the 7th day after admission ,serum concentrations of TNF‐α,IL‐1 and IL‐6 almost returned to the baseline. APACHEⅡ score and CTSI of SAP group were significantly higher than MAP group. In MAP group and SAP group ,serum levels of IL‐1 ,IL‐6 and TNF‐αwere positively correlated with APACHE Ⅱ score and CTSI at the 3rd day after admission (P<0. 01). Conclusion Detection of serum TNF‐α,IL‐1 and IL‐6 levels could be beneficial fro the assessment of disease severity and prognosis for AP.