Changes in serum levels of M30,M65,and IL-17 and their clinical significance in patients with acute pancreatitis
-
摘要: 目的探讨急性胰腺炎(AP)患者血清M30、M65及IL-17水平的变化及临床意义。方法选取2009年12月-2013年12月延安大学附属医院收治的126例AP患者,根据临床诊断分为轻度急性胰腺炎(82例)和急性重症胰腺炎(44例)。选择同期本院体检中心体检的健康人员107例为对照组,分别于第1、2、4天分析3组患者血清中M30、M65、白细胞介素(IL)17水平,以及血清M30/M65值。计量资料多组间比较采用方差分析,进一步两两比较采用SNK-q检验,两组间比较采用独立样本t检验;计数资料组间比较采用χ2检验。结果急性重症胰腺炎及轻度急性胰腺炎患者在第1、2、4天时其血清M30、M65、IL-17水平均显著高于健康受试者(P值均<0.05),而M30/M65比值则显著低于健康受试者(P<0.001);急性重症胰腺炎患者在第1、2、4天时其血清M30、M65水平均显著高于轻度急性胰腺炎患者(P值均<0.001),急性重症胰腺炎患者的M30/M65值则在第1天时显著低于轻度胰腺炎患者(P值均<0.001),但IL-17在轻度急性胰腺炎患者与急性重症胰腺炎患者间差异...Abstract: Objective To investigate the changes in serum levels of M30,M65,and interleukin- 17( IL- 17) and their clinical significance in patients with acute pancreatitis. Methods A total of 126 patients with acute pancreatitis who were admitted to our hospital from December 2009 to December 2013 were selected,and according to clinical diagnosis,they were divided into mild acute pancreatitis group( 82 patients) and severe acute pancreatitis group( 44 patients). A total of 107 healthy subjects who underwent physical examination during the same period of time were enrolled as the control group. On days 1,2,and 4,the serum levels of M30,M65,and IL- 17 were measured,and M30 / M65 ratio was calculated. Comparison of coutinous data between multiple groups was made by ANOVA and pairwise comparison between any two groups was made by SNK- q test,comparison between two groups was made by independent- sample t test,while comparison of categorical data by chisquare test. Results On days 1,2,and 4,the severe acute pancreatitis group and mild acute pancreatitis group had significantly higher serum levels of M30,M65,and IL- 17( P < 0. 05),and a significantly lower M30 / M65 ratio( P <0. 001),as compared with the healthy controls. On days 1,2,and 4,the severe acute pancreatitis group had significantly higher serum levels of M30 and M65 than the mild acute pancreatitis group( P < 0. 001); on day 1,the severe acute pancreatitis group had a significantly lower M30 / M65 ratio than the mild acute pancreatitis group( P < 0. 001); the serum level of IL- 17 showed no significant difference between the two groups( P > 0. 05). M65 and IL- 17 had high sensitivity and specificity in the diagnosis of acute pancreatitis. Conclusion The serum levels of M65 and IL- 17 and M30 / M65 ratio at 24 hours after the attack of acute pancreatitis can be used as the serological biomarkers for early evaluation of the severity of acute pancreatitis.
-
Key words:
- pancreatitis /
- keratin-18 /
- interleukin-17 /
- early diagnosis
-
[1]BANKS PA,FREEMAN ML.Practice guidelines in acute pancreatitis[J].Am J Gastroenterol,2006,101(10):2379-2400. [2]PONGPRASOBCHAI S,JIANJAROONWONG V,CHARATCHAROENWITTHAYA P,et al.Erythrocyte sedimentation rate and C-reactive protein for the prediction of severity of acute pancreatitis[J].Pancreas,2010,39(8):1226-1230. [3]GUKOVSKAYA AS,PANDOL SJ.Cell death pathways in pancreatitis and pancreatic cancer[J].Pancreatology,2004,4(6):567-586. [4]NUEZ G,BENEDICT MA,HU Y,et al.Caspases:the proteases of the apoptotic pathway[J].Oncogene,1998,17(25):3237-3245. [5]CAULIN C,SALVESEN GS,OSHIMA RG.Caspase cleavage of keratin 18 and reorganization of intermediate filaments during epithelial cell apoptosis[J].J Cell Biol,1997,138(6):1379-1394. [6]CRAIG DG,LEE P,PRYDE EA,et al.Circulating apoptotic and necrotic cell death markers in patients with acute liver injury[J].Liver Int,2011,31(8):1127-1136. [7]BANCHEREAU J,PASCUAL V,O'GARRA A.From IL-2 to IL-37:the expanding spectrum of anti-inflammatory cytokines[J].Nat Immunol,2012,13(10):925-931. [8]Pancreas Study Group,Chinese Society of Gastroenterology,Chinese Medical Association.Chinese guidelines for the management of acute pancreatitis(draft)[J].Chin J Int Med,2004,43(3):236-238.(in Chinese)中华医学会消化病学分会胰腺疾病学组.中国急性胰腺炎诊治指南(草案)[J].中华内科杂志,2004,43(3):236-238. [9]BANKS PA,FREEMAN ML.Pratice guidelines in acute pancreatitis[J].AM J Gastroenterol,2006,101(10):2379-2400. [10]BARRETO SG,RODRIGUES J.Comparison of APACHEⅡand Imrie Scoring Systems in predicting the severity of acute pancreatitis[J].World J Emerg Surg,2007,2:33. [11]BCHLER M,MALFERTHEINER P,SCHOETENSACK C,et al.Sensitivity of antiproteases,complement factors and C-reactive protein in detecting pancreatic necrosis.Results of a prospective clinical study[J].Int J Pancreatol,1986,1(3-4):227-235. [12]NEOPTOLEMOS JP,KEMPPAINEN EA,MAYER JM,et al.Early prediction of severity in acute pancreatitis by urinary trypsinogen activation peptide:a multicentre study[J].Lancet,2000,355(9219):1955-1960. [13]SUNG KF,ODINOKOVA IV,MARENINOVA OA,et al.Prosurvival Bcl-2 proteins stabilize pancreatic mitochondria and protect against necrosis in experimental pancreatitis[J].Exp Cell Res,2009,315(11):1975-1989. [14]SCHUTTE B,HENFLING M,KLGEN W,et al.Keratin 8/18breakdown and reorganization during apoptosis[J].Exp Cell Res,2004,297(1):11-26. [15]MIOSSEC P,KOLLS JK.Targeting IL-17 and TH17 cells in chronic inflammation[J].Nat Rev Drug Discov,2012,11(10):763-776.
本文二维码
计量
- 文章访问数: 2382
- HTML全文浏览量: 43
- PDF下载量: 450
- 被引次数: 0