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目的探讨外周血中性粒细胞凋亡在重症急性胰腺炎(SAP)发病机制中的作用,以及生长抑素(SS)和生长激素(GH)对外周血中性粒细胞凋亡水平的调节作用。方法采用流式细胞仪检测重症急性胰腺炎外周血中性粒细胞凋亡水平,以及SS、SS+GH序贯疗法对中性粒细胞凋亡的影响。结果SAP患者外周血中,中性粒细胞凋亡明显延缓。MODS患者的中性粒细胞凋亡延缓较SIRS患者显著。SS治疗能纠正中性粒细胞凋亡延缓(P<0.05)。SS+GH序贯疗法组与SS组比较差异无显著性(P=0.05)。结论中性粒细胞凋亡延缓是重症急性胰腺炎发病的重要机制,并与疾病的严重程度相关。生长抑素通过改善中性粒细胞凋亡,对重症急性胰腺炎有治疗作用,与生长激素联用,有协同作用。
Objective To investigate the role of peripheral blood neutrophil apoptosis in the pathogenesis of severe acute pancreatitis (SAP) and the role of somatostatin (SS) and growth hormone (GH) in the regulation of peripheral blood neutrophil apoptosis . Methods Flow cytometry was used to detect the apoptosis of peripheral blood neutrophils in patients with severe acute pancreatitis and the effect of SS and SS + GH sequential therapy on neutrophil apoptosis. Results In peripheral blood of patients with SAP, apoptosis of neutrophils was significantly delayed. Prolonged apoptosis of neutrophils in patients with MODS is more significant than in patients with SIRS. SS treatment can correct the delay of neutrophil apoptosis (P <0.05). SS + GH sequential therapy group and SS group no significant difference (P = 0.05). Conclusion The delayed apoptosis of neutrophils is an important mechanism of the pathogenesis of severe acute pancreatitis and is related to the severity of the disease. Somatostatin by improving neutrophil apoptosis, the treatment of severe acute pancreatitis, combined with growth hormone, synergistic effect.