目的：探讨急性胰腺炎（acute pancreatitis, AP）患者血清内皮素（endothelin, ET）和炎性细胞因子水平测定的临床意义。方法放射免疫分析和高敏酶免疫分析测定了136例AP患者，包括重症急性胰腺炎（severe acute pancreatitis, SAP）75例和中轻症急性胰腺炎（mild acute pancreatitis, MAP）61例，以及60名正常对照组血清ET、白介素-2（interlukin-2, IL-2）、白介素-8（interlukin-8, IL-8）、肿瘤坏死因子-α（tumor necrosis factor-α, TNF-α）和高敏C-反应蛋白（high sensitive C-reaction protein, hs-CRP）并进行了比较性分析。结果与正常对照组比较，AP患者的血清IL-2明显降低（P＜0.05）， IL-8、TNF-ɑ和hs-CRP明显增高（P均＜0.01）；SAP患者IL-2明显降低（P＜0.01），ET、IL-8、TNF-ɑ和hs-CRP明显增高（P＜0.05或P＜0.01）；MAP患者ET明显降低（P＜0.05），TNF-ɑ和hs-CRP明显增高（P均＜0.05）。以上表明：血清ET、IL-8、TNF-α和hs-CRP水平随AP的严重程度而增高，血清IL-2水平随严重程度而降低。结论血清ET和炎性细胞因子是评价AP严重程度的有价值指标，以便早期诊断和早期治疗。%Objective To explore the clinical significance of serum endothelin (ET) and cytokines levels in patients with acute pancreatitis (AP). Methods The serum and cytokines (IL-2, IL-8, TNF-αand hs-CRP) levels in 136 patients with AP (including 75 cases SAP and 61 cases MAP) and 60 controls were determined by radioimmunoassay and high sensitive enzyme immunoassay was comparatively analyzed. Results In patients with AP, the serum IL-2 levels significantly decreased than that in controls (P<0.05), but the serum IL-8, TNF-αand hs-CRP levels significantly increased (all P<0.01);In patients with SAP, the serum IL-2 levels significantly decreased than that in controls (P<0.01), but the serum ET, IL-8, TNF-α and hs-CRP levels significantly increased (P<0.05 or P<0.01);In patients with MAP, the serum ET levels significantly decreased than that in controls (P<0.05), but the serum TNF-αand hs-CRP levels significantly increased (all P<0.01). The above showed that the serum ET, IL-8, TNF-αand hs-CRP levels increased with AP severity, but the serum IL-2 level decreased with AP severity. Conclusion The serum ET and cytokines (IL-2, IL-8, TNF-αand hs-CRP) levels are valuable indexes for exploring AP severity to ensure early diagnosis and early therapy.
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