双氯芬酸钠对经内镜逆行胰胆管造影术后胰腺炎患者非甾体类抗炎药激活基因1水平的影响

胡翠; 鲍峻峻; 刘晓昌; 丁少桢; 梅俏; 许建明

doi:10.3969/j.issn.1001-5256.2018.03.018

双氯芬酸钠对经内镜逆行胰胆管造影术后胰腺炎患者非甾体类抗炎药激活基因1水平的影响

DOI: 10.3969/j.issn.1001-5256.2018.03.018

安徽医科大学第一附属医院消化内科消化系统疾病省级重点实验室

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- 出版日期: 2018-03-20

Effect of diclofenac sodium on the level of non-steroidal anti-inflammatory drug-activated gene-1 in patients with post-ERCP pancreatitis

Department of Gastroenterology, The First Affiliated Hospital of Anhui Medical University & Anhui Provincial Key Laboratory of Digestive Diseases

摘要

摘要:
目的探讨双氯芬酸钠对经内镜逆行胰胆管造影（ERCP）术后胰腺炎（PEP）患者非甾体类抗炎药激活基因1（NAG-1）水平的影响。方法收集2012年9月-2013年10月于安徽医科大学第一附属医院行ERCP的患者120例,随机分为双氯芬酸钠组和对照组,每组60例。双氯芬酸钠组患者ERCP术后立即肌注奥尔芬1支（含双氯芬酸钠75 mg）,对照组不肌注。收集2组患者术前、术后3 h及术后24 h血液,行淀粉酶检测,并观察腹痛发生情况,计算2组患者PEP发生率。分别采用RT-PCR及Western Blot方法检测血浆中NAG-1 mRNA及蛋白表达情况。计量资料采用重复测量的方差分析,满足球形检验时,采用单变量方差分析,不满足球形检验时,采用Greenhouse-Geisser校正方法。计数资料2组间比较采用χ2检验。结果双氯芬酸钠组PEP发生率（4/60,6.67%）显著低于对照组（12/60,20.00%）（χ2=4.62,P=0.03）。双氯芬酸钠组术后3 h[（202.70±120.44）U/L vs（283.57±178.39）U/L]、术...
- 胰腺炎 /
- 胰胆管造影术,内窥镜逆行 /
- 二氯芬酸 /
- 非甾体类抗炎药激活基因1
Abstract:
Objective To investigate the effect of diclofenac sodium on the level of non-steroidal anti-inflammatory drug-activated gene-1 ( NAG-1) in patients with post-ERCP pancreatitis ( PEP) . Methods A total of 120 patients who underwent ERCP in The First Affiliated Hospital of Anhui Medical University from September 2012 to October 2013 were enrolled and randomly divided into diclofenac sodium group and control group, with 60 patients in each group. The patients in the diclofenac sodium group were given intramuscular injection of Olfen ( containing diclofenac sodium 75 mg) immediately after ERCP. Blood samples were collected before surgery and at 3 and 24 hours after surgery, and the level of amylase was measured. The incidence of abdominal pain was also observed and the incidence rate of PEP was calculated for both groups. RT-PCR and Western blot were used to measure the mRNA and protein expression of NAG-1 in plasma. An repeated-measures analysis of variance was used for comparison of continuous data; a univariate analysis of variance was used for data meeting the requirements of sphericity test, and the Greenhouse-Geisser correction method was used for data which did not meet the requirements of sphericity test. The chi-square test was used for comparison of categorical data between groups. Results The diclofenac sodium group had a significantly lower incidence rate of PEP than the control group [6. 67% ( 4/60) vs 20. 00% ( 12/60) , χ2= 4. 62, P = 0. 03].The diclofenac sodium group had a significantly lower level of amylase than the control group at 3 and 24 hours after surgery ( at 3 hours after surgery: 202. 70 ± 120. 44 U/L vs 283. 57 ± 178. 39 U/L, t = 2. 06, P < 0. 05; at 24 hours after surgery: 209. 13 ± 157. 14 U/L vs 305. 97 ±208. 69 U/L, t = 2. 03, P < 0. 05) . At 3 hours after ERCP, the diclofenac sodium group had significant increases in the mRNA and protein expression of NAG-1 in plasma and significantly higher mRNA and protein expression of NAG-1 than the control group ( all P < 0. 01) .Conclusion Diclofenac sodium can prevent PEP, possibly by promoting the level of NAG-1.
- pancreatitis /
- cholangiopancreatography, endoscopic retrograde /
- diclofenac /
- NSAID activated gene 1

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参考文献(18)

[1]RABENSTEIN T, SCHNEIDER HT, HAHN EG, et al.25 years of endoscopic sphincterotomy in Erlangen:assessment of the experience in 3498 patients[J].Endoscopy, 1998, 30 (9) :a194-a201.

[2]KOCHAR B, AKSHINTALA VS, AFGHANI E, et al.Incidence, severity, and mortality of post-ERCP pancreatitis:a systematic review by using randomized, controlled trials[J].Gastrointest Endosc, 2015, 81 (1) :143-149.e9.

[3]SENOL A, SARITAS U, DEMIRKAN H.Efficacy of intramuscular diclofenac and fluid replacement in prevention of post-ERCP pancreatitis[J].World J Gastroenterol, 2009, 15 (32) :3999-4004.

[4]KHOSHBATEN M, KHORRAM H, MADAD L, et al.Role of diclofenac in reducing post-endoscopic retrograde cholangiopancreatography pancreatitis[J].J Gastroenterol Hepatol, 2008, 23 (7 Pt2) :e11-e16.

[5]ELMUNZER BJ, SCHEIMAN JM, LEHMAN GA, et al.Cooperative for Outcomes Research in Endoscopy (USCORE) .A randomized trial of rectal indomethacin to prevent post-ERCP pancreatitis[J].N Engl J Med, 2012, 366 (15) :1414-1422.

[6]ELMUNZER BJ, WALJEE AK, ELTA GH, et al.A meta-analysis of rectal NSAIDs in the prevention of post-ERCP pancreatitis[J].Gut, 2008, 57 (9) :1262-1267.

[7]DAI HF, WANG XW, ZHAO K.Role of nonsteroidal anti-inflammatory drugs in the prevention of post-ERCP pancreatitis:a meta-analysis[J].Hepatobiliary Pancreat Dis Int, 2009, 8 (1) :11-16.

[8]MURRAY B, CARTER R, IMRIE C, et al.Diclofenac reduces the incidence of acute pancreatitis after endoscopic retrograde cholangiopancreatography[J].Gastroenterology, 2003, 124 (7) :1786-1791.

[9]CHEON YK, CHO KB, WATKINS JL, et al.Efficacy of diclofenac in the prevention of post-ERCP pancreatitis in predominantly high-risk patients:a randomized double-blind prospective trial[J].Gastrointest Endosc, 2007, 66 (6) :1126-1132.

[10]COTTON PB, LEHMAN G, VENNES J, et al.Endoscopic sphincterotomy-complications and their management:an attempt at consensus[J].Gastrointest Endosc, 1991, 37 (3) :383-393.

[11]LI X, TAO LP, WANG CH.Effectiveness of nonsteroidal anti-infl ammatory drugs in prevention of post-ERCP pancreatitis:a metaanalysis[J].World J Gastroenterol, 2014, 20 (34) :12322-12329.

[12]BAEK SJ, KIM KS, NIXON JB, et al.Cyclooxygenase inhibitors regulate the expression of a TGF-beta superfamily member that has proapoptotic and antitumorigenic activities[J].Mol Pharmacol, 2001, 59 (4) :901-908.

[13]BOOTCOV MR, BAUSKIN AR, Valenzuela SM, et al.MIC-1, a novel macrophage inhibitory cytokine, is a divergent member of the TGF-beta superfamily[J].Proc Natl Acad Sci U S A, 1997, 94 (21) :11514-11519.

[14]FAIRLIE WD, MOORE AG, BAUSKIN AR, et al.MIC-1 is a novel TGF-beta superfamily cytokine associated with macrophage activation[J].J Leukoc Biol, 1999, 65 (1) :2-5.

[15]BROWN DA, MOORE J, JOHNEN H, et al.Serum macrophage inhibitory cytokine 1 in rheumatoid arthritis:a potential marker of erosive joint destruction[J].Arthritis Rheum, 2007, 56 (3) :753-764.

[16]KIM JM, KOSAK JP, KIM JK, et al.NAG-1/GDF15 transgenic mouse has less white adipose tissue and a reduced inflammatory response[J].Mediators Inflamm, 2013, 2013:641851.

[17]KEMPF T, ZARBOCK A, WIDERA C, et al.GDF-15 is an inhibitor of leukocyte integrin activation required for survival after myocardial infarction in mice[J].Nat Med, 2011, 17 (5) :581-588.

[18]SHIM M, ELING TE.Vitamin E succinate induces NAG-1 expression in a p38 kinase-dependent mechanism[J].Mol Cancer Ther, 2008, 7 (4) :961-971.

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