生长抑素对急性重症胰腺炎患者外周血TNFα水平的影响

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目的 观察急性重症胰腺炎患者外周血肿瘤坏死因子α(TNFα)水平 ,以及施他宁对其的影响 ,为TNFα应用于急性胰腺炎的评估及施他宁应用于该病的治疗提供进一步的依据。方法 急性重症胰腺炎患者随机分成对照组 (n =10 )和治疗组 (n =10 ) ,两组入院第 1d抽血检测TNFα。对照组每d静滴 5 Fu 10 0 0mg ,共 3d ;治疗组静滴施他宁 5 0 0 μg ,维持 2 4h。 3d后抽血复查TNFα。另选同期非胰腺炎患者 8例于入院第 1d检测TNFα作基线对照。结果  8例非胰腺炎患者外周血TNFα低于检测下限 (10 pg/ml) ,入院第 1d对照组和治疗组TNFα分别为 2 5 9.12± 10 5 .6 9pg/ml和2 5 1.32± 110 .47pg/ml,两者差异不显著。 3d后治疗组TNFα为16 6 .33± 5 0 .72 pg/ml,较对照组2 12 .0 5± 6 2 .0 4pg/ml,明显降低。 结论 急性重症胰腺炎患者入院第 1d即有TNFα显著升高 ,可作为评价本病严重程度的指标。早期应用施他宁能部分抑制重症胰腺炎患者外周血TNFα水平。这是施他宁治疗急性胰腺炎的一个重要机制 Objective To observe the level of tumor necrosis factor α (TNFα) in peripheral blood of patients with acute severe pancreatitis and its effect on the expression of TNFα in acute pancreatitis and to provide further basis for its application in the treatment of this disease . Methods Patients with acute severe pancreatitis were randomly divided into control group (n = 10) and treatment group (n = 10). Blood samples were collected on the first day of admission to detect TNFα. The control group was given 5 Fu 10 0 mg intravenously every d for 3 days. The treatment group was given intravenous Shituning 500 μg for 24 hours. After 3d blood examination of TNFα. In the same period, 8 patients with non-pancreatitis were enrolled in the first day of hospital admission to detect TNFα as baseline control. Results The TNFα levels in the peripheral blood of 8 non-pancreatitis patients were lower than the lower limit of detection (10 pg / ml). The TNFα levels of the control group and the treatment group on the first day after admission were 25.09 ± 10.56.9pg / ml and 25.132 ± 110, respectively. 47pg / ml, no significant difference between the two. After 3 days, the treatment group TNFα was 16.633 ± 50.72 pg / ml, which was significantly lower than that of the control group (21.02 ± 0.524 pg / ml). Conclusions Patients with acute severe pancreatitis have a significant increase in TNFα on the first day after admission, which can be used as an index to evaluate the severity of the disease. Early application of thantadine can partially inhibit peripheral blood TNFα levels in patients with severe pancreatitis. This is Shitainin treatment of acute pancreatitis is an important mechanism
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