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目的了解急性胰腺炎病人血清肿瘤坏死因子(TNF)及受体(TNFR)变化与急性胰腺炎的关系。方法对急性充血水肿性胰腺炎组(AEP)12例和急性出血坏死性胰腺炎组(ANP)10例病人外周血液 TNF及可溶性 s-TNFR_(75)浓度在起病第1、3、5、7天进行检测。结果胰腺炎起病第1天 AEP 和 ANP 组病人血TNF 明显高于对照组(P<0.01),ANP 病人血 TNF 显著高于 AEP 组病人(P<0.05)。入院后两组 TNF 呈下降趋势,第7天两组血 TNF 接近正常,起病第5与第7天血 TNF 比较差异无显著意义(P>0.05),两组血 TNF 浓度在起病第1、3天与第5、7天间差异有显著意义(P<0.05)。两组病人 s-TNFRT_(75)在起病1至7天呈下降趋势,第1、3天和第5天间 s-TNFR_(75)比较差异无显著意义(P>0.05),第7天才明显下降(P<0.05)。AEP 和 ANP 组间比较,ANP 病人血清 s-TNFR_(75)在第1及第3天高于 AEP 病人(P<0.05),而第5、7天两组差异无显著意义(P>0.05)。结论 AEP 和 ANP 病人在炎症早期血 TNF 及 s-TNFR_(75)明显升高,随着急性炎症消退,呈下降趋势,第7天降到正常,ANP 组病人 TNF 及受体明显高于 AEP 组(P<0.05),与急性炎症充血水肿、出血坏死情况一致,可以认为 TNF 及 TNFR 参与了急性胰腺炎早期炎症的发生和发展,并与病情严重程度有关。
Objective To investigate the relationship between the changes of serum tumor necrosis factor (TNF) and its receptor (TNFR) and acute pancreatitis in patients with acute pancreatitis. Methods The concentrations of TNF and soluble s-TNFR_ (75) in peripheral blood of 12 patients with acute hyperemic and edematous pancreatitis (AEP) and 10 patients with acute hemorrhagic and necrotizing pancreatitis (ANP) 7 days for testing. Results On the first day after onset of pancreatitis, the level of TNF in serum of AEP and ANP patients was significantly higher than that of control group (P <0.01). The blood TNF of ANP patients was significantly higher than that of AEP patients (P <0.05). After admission, the TNF in both groups showed a decreasing trend. On the seventh day, the level of TNF in the two groups was close to normal. There was no significant difference in blood TNF between the 5th and 7th day after onset (P> 0.05) , There was significant difference between the 3rd day and the 5th and 7th day (P <0.05). There was no significant difference in s-TNFR_ (75) between the first and third days and the fifth day (P> 0.05) Decreased significantly (P <0.05). Serum levels of s-TNFR_ (75) in ANP patients were higher than those in AEP patients on the 1st and 3rd days (P <0.05), but no significant difference was found on the 5th and 7th days between the two groups (P> 0.05) . Conclusions The levels of TNF-α and TNF-α in serum of patients with AEP and ANP were significantly increased at the early stage of inflammation. With the gradual decline of acute inflammation, the levels of TNF and TNF-α in ANP group were significantly higher than those in AEP group (P <0.05). Consistent with the congestive, edema and hemorrhagic necrosis of acute inflammation, TNF and TNFR may be considered to be involved in the occurrence and development of early inflammation in acute pancreatitis, which is related to the severity of the disease.