重症急性胰腺炎患者老想睡觉_TNF-α和IL-6在重症急性胰腺炎患者血清中的变化及临床意义

　　[摘要] 目的 探讨TNF-α和IL-6在重症急性胰腺炎（SAP）患者血清中的动态变化及临床意义。 方法 选取2001年10月～2010年7月入住我院的急性胰腺炎患者60例，按照病情程度分为SAP组、轻症急性胰腺炎（MAP）组，每组30例，同时将健康体检者30例作为空白对照组，用ELISA法分别检测三组入院第1天、第3天、第7天、第14天血清TNF-α、IL-6的水平，结果进行统计学分析。 结果 入院时SAP组TNF-α水平[（59.6±14.7）pg/mL]显著高于MAP组[（38.3±9.1）pg/mL]和空白对照组[（13.8±4.3）pg/mL]（P ＜ 0.05），MAP组患者血清TNF-α水平也较空白对照组显著升高（P ＜ 0.05），但IL-6水平SAP组[（45.8±11.2）pg/mL]和MAP组[（42.9 ±12.9）pg/mL]均较空白对照组[（38.9±10.9）pg/mL]无明显升高（P ＞ 0.05）；SAP组血清IL-6在入院的第7天升高最明显[（190.1±49.9）pg/mL]，分别高于MAP组[（113.9±28.1）pg/mL]和空白对照组（P ＜ 0.05），MAP组亦明显高于空白对照组（P ＜ 0.05）；在入院第14天SAP组血清TNF-α[（36.8±7.1）pg/mL]、IL-6[（113.1±24.7）pg/mL]仍然高于MAP组[（14.8±3.3）、（43.6±12.8）pg/mL]和空白对照组（P ＜ 0.05），而MAP组与空白对照组比较差异无统计学意义（P ＞ 0.05）。 结论 重症急性胰腺炎患者治疗前后血清TNF-α和IL-6的水平变化，可以作为对该病的早期诊断、病情判断和预后评估的依据之一，具有重要的临床应用价值。
　　[关键词] 重症急性胰腺炎；肿瘤坏死因子-α；白细胞介素-6
　　[中图分类号] R576 [文献标识码] C [文章编号] 1673-7210（2012）07（a）-0157-02
　　Dynamic changes and clinical significance of serum TNF-α and IL-6 in severe acute pancreatitis
　　ZHONG Hong SHI Yong LI Guanqiang
　　Department of General Surgery, Longgang District People"s Hospital in Shenzhen City, Guangdong Province, Shenzhen 518172, China
　　[Abstract] Objective To investigate the dynamic changes and clinical significance of serum TNF-α and IL-6 in severe acute pancreatitis (SAP). Methods 60 cases who are admitted to our hospital with acute pancreatitis from October 2001 to July 2010 were selected and divided into mild acute pancreatitis (MAP) group and severe acute pancreatitis (SAP) group with the standard of severity, with 30 cases in each group, at the same time 30 cases of healthy persons were as control group, ELISA method was used to detect the serum TNF-alpha, IL-6 levels of three groups of hospitalized one day, three days, seven days, fourteen days, the results were statistically analyzed. Results The levels of TNF-α in SAP group [(59.6±14.7) pg/mL] were significantly higher than those in MAP group [(38.3±9.1) pg/mL] (P ＜ 0.05) and control group [(13.8±4.3) pg/mL] and the levels of TNF-α in MAP group were significantly higher than control group (P ＜ 0.05), but the levels of IL-6 were not significantly different among the three groups on admission [(45.8±11.2) pg/mL, (42.9 ±12.9) pg/mL, (38.9 ±10.9) pg/mL] (P ＞ 0.05). The levels of IL-6 in SAP group [(190.1±49.9) pg/mL] were significantly higher than those in MAP group [(113.9±28.1) pg/mL] (P ＜ 0.05) and control group and the levels in MAP group were significantly higher than control group on the seventh day after admission (P ＜ 0.05); the levels of TNF-α and IL-6 in SAP group [(36.8±7.1) pg/mL and [(113.1±24.7) pg/mL] were significantly higher than those in MAP group [(14.8±3.3) pg/mL and (43.6±12.8) pg/mL] (P ＜ 0.05) and control group but there were not significant differences between SAP group and control group on the fourteenth day after treatment (P ＞ 0.05). Conclusion The changes of different times of serum TNF-alpha and IL-6 levels of patients with severe acute serum, which can be used as early diagnosis of the disease, the condition judgment and the basis for prognostic evaluation, which has an important clinical value.