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[目的]探讨急性胰腺炎(AP)患者血清肿瘤坏死因子-α(TNF-α)水平动态变化对病情判断的价值以及与APACHEⅡ评分的相关性。[方法]36例AP患者分为轻症AP(MAP)组26例和重症AP(SAP)组10例,评定APACHEⅡ评分;对照组10例,均为健康志愿者。采用ELISA法检测血清TNF-α水平。[结果]①入院第1天2患者组血清TNF-α水平较对照组明显升高(P<0.05);随后MAP组逐渐下降,第7天降至正常;SAP组则持续升高,第3天达峰值;第3、7、14天明显高于MAP组(P<0.05)。②SAP组的TNF-α水平和APACHEⅡ评分明显高于MAP组,血清TNF-α水平与APACHEⅡ评分呈显著正相关(r=0.837,P<0.01)。[结论]AP患者血清TNF-α水平变化与APACHEⅡ评分有良好的相关性;TNF-α水平变化与AP的发生发展密切相关,入院第3天的TNF-α水平可作为AP病情程度判断的参考指标,测定TNF-α水平有助于判断预后。
[Objective] To investigate the value of serum tumor necrosis factor-α (TNF-α) level in patients with acute pancreatitis (AP) and its relationship with APACHEⅡ score. [Methods] Thirty-six patients with AP were divided into mild AP group (26 cases) and severe AP group (SAP group) with 10 cases. The APACHEⅡscore was assessed in the 36 cases. The control group included 10 healthy volunteers. Serum TNF-α levels were measured by ELISA. [Results] ① On the first day after admission, serum TNF-α levels in 2 patients were significantly higher than those in the control group (P <0.05); then the MAP group decreased gradually and dropped to normal on the 7th day; Day peak; 3,7,14 days was significantly higher than the MAP group (P <0.05). ② The level of TNF-α and APACHEⅡ in SAP group were significantly higher than those in MAP group. There was a significant positive correlation between serum TNF-α and APACHEⅡscore (r = 0.837, P <0.01). [Conclusion] There is a good correlation between the change of serum TNF-α level and APACHEⅡscore in AP patients. The change of TNF-α level is closely related to the occurrence and development of AP. The level of TNF-α on the 3rd day of hospital admission can be used as a reference for judging the severity of AP Indicators, determination of TNF-α levels help to determine the prognosis.