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目的:探讨急性胰腺炎患者血浆中致炎因子肿瘤坏死因子-α(TNF-α)、白介素-6(IL-6)和抗炎因子转化细胞生长因子-β(TGF-β)、白介素-10(IL-10)的变化、意义及生长抑素的调节作用。方法:急性胰腺炎48例,随机分成生长抑素治疗组和常规治疗组,分别在治疗前(入院时)、治疗后8 h和第2、3、4 d清晨空腹抽肘静脉血3 ml,测定TNF-α、IL-6、TGF-β和IL-10,并设对照组。结果:TNF-α和IL-6各监测点均比对照组显著升高(P<0.05,P<0.01),高峰在入院时。TGF-β和IL-10入院后8 h以后各监测点均比对照组显著升高(P<0.05,P<0.01);第2天达高峰。生长素抑素治疗组TNT-α、IL-6、和TGF-β、IL-10含量治疗后8 h明显低于常规治疗组。治疗后各观察点持续降低(P<0.05,P<0.01)。结论:急性胰腺炎患者血中致炎因子与抗炎因子均升高,机体免疫功能紊乱。生长抑素对致炎因子与抗炎因子的升高有抑制作用。
Objective: To investigate the changes of plasma levels of inflammatory cytokines TNF-α, IL-6 and anti-inflammatory cytokines TGF-β, (IL-10) changes, the significance and the regulation of somatostatin. Methods: Forty-eight cases of acute pancreatitis were randomly divided into the somatostatin treatment group and the conventional treatment group. Blood samples were collected from the antecubital vein 3 ml before treatment (at admission), 8 h after treatment and on the 2nd, The levels of TNF-α, IL-6, TGF-β and IL-10 were determined and the control group was established. Results: The levels of TNF-α and IL-6 were significantly higher than those of the control group (P <0.05, P <0.01). The peak was on admission. The levels of TGF-β and IL-10 in all monitoring sites after 8 h were significantly higher than those in the control group (P <0.05, P <0.01), and peaked on the second day. The levels of TNT-α, IL-6, TGF-β and IL-10 in the somatostatin treatment group were significantly lower than those in the conventional treatment group at 8 h after treatment. After treatment, the observation points continued to decrease (P <0.05, P <0.01). Conclusion: Serum inflammatory and anti-inflammatory cytokines are elevated in patients with acute pancreatitis, and the immune function is disturbed. Somatostatin can inhibit the increase of inflammatory cytokines and anti-inflammatory cytokines.