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目的:探讨乌司他汀对重症急性胰腺炎儿童炎症因子和T淋巴细胞的影响,为临床治疗提供理论依据。方法:将重症急性胰腺炎儿童分为乌司他汀联合常规治疗组(UTN组)和常规治疗组(CON组),比较两组研究对象治疗前后高敏C反应蛋白(hs-CRP)、TNF-α、IL-6、IL-8、IL-10、淋巴细胞(Lym)、T淋巴细胞亚群(CD3+、CD4+和CD8+)的差异。结果:UTN组和CON组重症急性胰腺炎儿童治疗前的hs-CRP、TNF-α、IL-6、IL-8和IL-10差异无统计学意义(P>0.05),两组研究对象治疗后hs-CRP、TNF-α、IL-6、IL-8均显著降低,差异有统计学意义(P均<0.05),IL-10均显著升高,差异有统计学意义(P均<0.05);UTN组儿童治疗后的hs-CRP、TNF-α、IL-6和IL-8均显著低于CON组,差异有统计学意义(P均<0.05),IL-10显著高于CON组,差异有统计学意义(均P<0.05)。UTN组和CON组重症急性胰腺炎儿童治疗前Lym、CD3+、CD4+和CD8+水平比较,差异无统计学意义(P均>0.05),两组研究对象治疗后Lym、CD3+和CD4+淋巴细胞均显著增加,差异有统计学意义(P均<0.05),CD8+淋巴细胞显著降低,差异有统计学意义(P均<0.05);UTN组儿童治疗后的Lym、CD3+和CD4+淋巴细胞均显著高于CON组,差异有统计学意义(P均<0.05),CD8+淋巴细胞显著低于CON组,差异有统计学意义(P均<0.05)。结论:乌司他汀可显著降低重症急性胰腺炎儿童血清hs-CRP、TNF-α、IL-6、IL-8,提高IL-10和T淋巴细胞免疫水平。
Objective: To investigate the effect of ulinastatin on inflammatory cytokines and T lymphocytes in children with severe acute pancreatitis, and to provide a theoretical basis for clinical treatment. Methods: The children with severe acute pancreatitis were divided into ulinastatin group (UTN group) and conventional treatment group (CON group). The levels of hs-CRP, TNF-α , IL-6, IL-8, IL-10, lymphocytes (Lym), T lymphocyte subsets (CD3 +, CD4 + and CD8 +). Results: There was no significant difference in hs-CRP, TNF-α, IL-6, IL-8 and IL-10 levels between UTN group and CON group in children with severe acute pancreatitis (P> 0.05) The levels of hs-CRP, TNF-α, IL-6 and IL-8 were significantly decreased after treatment (all P <0.05), and IL-10 were significantly increased ); The levels of hs-CRP, TNF-α, IL-6 and IL-8 in UTN group were significantly lower than those in CON group (all P <0.05) , The difference was statistically significant (both P <0.05). The levels of Lym, CD3 +, CD4 + and CD8 + in UTN and CON children with severe acute pancreatitis before treatment were not significantly different (all P> 0.05). The Lym, CD3 + and CD4 + lymphocytes in two groups were significantly increased , The difference was statistically significant (P <0.05), CD8 + lymphocytes was significantly lower, the difference was statistically significant (all P <0.05); Lym, CD3 and CD4 lymphocytes in UTN group after treatment were significantly higher than CON group , The difference was statistically significant (P <0.05), CD8 + lymphocytes was significantly lower than the CON group, the difference was statistically significant (P all <0.05). Conclusion: Ulinastatin can significantly reduce serum hs-CRP, TNF-α, IL-6 and IL-8 in children with severe acute pancreatitis and increase the level of IL-10 and T lymphocyte immunity.