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目的探讨TNF-α对重症急性胰腺炎合并腹腔间隔室综合征的早期识别及其意义。方法选取重症急性胰腺炎患者32例(SAP组),重症急性胰腺炎合并腹腔间隔室综合征患者30例(SAP合并ACS组),健康体检者30例(对照组)。患者于入院第2天清晨取空腹静脉血,采用酶联免疫吸附测定法(ELISA法)检测血清TNF-α水平。通过检测膀胱内压间接测定腹内压。结果 1SAP合并ACS组、SAP组与对照组TNF-α差异均有统计学意义(P<0.01),SAP合并ACS组与SAP组TNF-α差异有统计学意义(P<0.01);2SAP合并ACS组与SAP组相比,两组腹内压的差异有统计学意义(P<0.01);3腹内压越高,TNF-α越高,两者呈线性正相关(r=0.61)。结论 TNF-α与腹内压呈线性正相关,且TNF-α水平越高,提示SAP患者出现ACS的可能性越大,TNF-α对重症急性胰腺炎合并腹腔间隔室综合征的早期识别有重要意义。
Objective To investigate the early identification and significance of TNF-α in patients with severe acute pancreatitis complicated with abdominal compartment syndrome. Methods Thirty-two patients with severe acute pancreatitis (SAP group), 30 patients with severe acute pancreatitis complicated by abdominal compartment syndrome (SAP group with ACS) and 30 healthy controls (control group) were selected. Fasting venous blood was collected on the second day of admission and the level of serum TNF-α was measured by enzyme-linked immunosorbent assay (ELISA). Indirect determination of intra-abdominal pressure by detecting intravesical pressure. Results There was a significant difference in TNF-α between SAP group and control group (P <0.01), there was a significant difference of TNF-α between ACS group and SAP group (P <0.01) Compared with SAP group, there were significant differences in intra-abdominal pressure between the two groups (P <0.01) .3 The higher the intra-abdominal pressure and the higher the TNF-α, the two showed a positive correlation (r = 0.61). Conclusions TNF-α is positively correlated with intra-abdominal pressure. The higher the level of TNF-α, the greater the possibility of ACS in patients with SAP. The early identification of TNF-α in patients with severe acute pancreatitis complicated with abdominal compartment syndrome Significance.