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目的 探讨细胞因子和T细胞亚群在重症急性胰腺炎 (severeacutepancreatitis ,SAP)中的变化及临床意义。方法 应用双抗体夹心ELISA法检测重症急性胰腺炎和轻型急性胰腺炎 (mildacutepancreatitis ,MAP)及对照组的血清IL - 6、IL - 8的含量 ;应用碱性磷酸酶桥联法 (APAAP)检测T细胞亚群。结果 重症急性胰腺炎发病初期IL - 6、IL - 8已升高 ,明显高于轻型急性胰腺炎和对照组 (P <0 .0 0 1) ;轻型急性胰腺炎明显高于对照组 (P <0 .0 1)。重症急性胰腺炎的CD+ 4、CD+ 8均明显低于轻型急性胰腺炎和对照组 (P <0 .0 1) ,尤以发病第 3～ 7天明显 ,但CD+ 3 和CD+ 4/CD+ 8比值无显著性差异 (P >0 .0 5 ) ,轻型急性胰腺炎的T细胞亚群与对照组间无显著性差异 (P>0 .0 5 )。重症急性胰腺炎治疗好转期IL - 6、IL - 8与治疗前比有非常显著性差异 (P <0 .0 0 1) ,加重或恶化者IL- 6、IL - 8持续上升 ;好转患者CD+ 4、CD+ 8恢复正常 ,恶化者保持下降。结论 IL - 6、IL - 8和T细胞亚群的变化 ,对重症急性胰腺炎的早期诊断、病情判断和预后评估具有重要的应用价值
Objective To investigate the changes and clinical significance of cytokines and T lymphocyte subsets in patients with severe acute pancreatitis (SAP). Methods Serum levels of IL - 6 and IL - 8 in patients with severe acute pancreatitis and mild acute pancreatitis (MAP) and control group were detected by double antibody sandwich ELISA. The levels of T Cell subpopulation. Results The levels of IL - 6 and IL - 8 in early stage of severe acute pancreatitis were significantly higher than those in mild acute pancreatitis and control group (P <0.01). The levels of IL - 6 and IL - 8 in acute severe acute pancreatitis were significantly higher than those in control group (P < 0 .0 1). CD + 4 and CD + 8 of severe acute pancreatitis were significantly lower than those of mild acute pancreatitis and control group (P <0.01), especially on days 3 to 7, but the ratios of CD + 3 and CD + 4 / CD + 8 There was no significant difference (P> 0.05). There was no significant difference in T cell subsets between control group and mild acute pancreatitis (P> 0.05). The levels of IL - 6 and IL - 8 in patients with severe acute pancreatitis improved significantly compared with those before treatment (P <0.01), while the levels of IL - 6 and IL - 8 in patients with severe acute pancreatitis continued to increase. 4, CD + 8 returned to normal, deteriorating decline. Conclusion The changes of IL - 6, IL - 8 and T cell subsets have important value in the early diagnosis, judgment and prognosis of severe acute pancreatitis