目的 探讨血必净改善急性胰腺炎患者炎症反应的可能机制.方法 选取急性胰腺炎发作且24 h以内入院的患者79例,随机分为血必净治疗组(n=41)和常规治疗组(n=38),同时选取33例健康体检人员作为对照组.3组分别于入院后第1、3天和第1、2周抽取血液,采用酶联免疫吸附剂测定法(ELISA)测定血清细胞因子肿瘤坏死因子-α(TNF-α)、白介素-1β(IL-1β)及白介素-6(IL-6)的质量浓度.结果 急性胰腺炎患者血清TNF-α、IL-1β及IL-6质量浓度在急性胰腺炎发作后快速上升,第1天到达峰值；至发病第3天,其TNF-α、IL-1β及IL-6质量浓度仍高于对照组；至第1周,其血清TNF-α、IL-1β质量浓度仍高于对照组.和常规治疗组相比,血必净治疗组在第3天及第1周时,TNF-α质量浓度显著降低；IL-1β和IL-6质量浓度在第3天即显著降低.结论 血必净在早期能够降低急性胰腺炎患者血清细胞因子TNF-α、IL-1β及IL-6的质量浓度,通过抑制炎症反应来保护胰腺及其他器官,这可能是血必净治疗急性胰腺炎的作用机制之一.%Objective To investigate the effects of Xuebijing injection on serum concentrations of TNF-α,IL-1β and IL-6 in patients with acute pancreatitis(AP).Method A total of 79 patients were randomly divided into Xuebijing group (n =41) and conventional treatment group (n =55) with 33 healthy volunteers as a control group.ELISA was applied to measure the serum concentration of these cytokine:TNF-α,IL-1β and IL-6 at different time points(1 d,3 d,1 w,2 w after the onset of AP).Results The serum of concentrations of TNF-α,IL-1β and IL-6 reached the maximum on the first day when AP occurred,the serum concentration of TNF-α,IL-1β and IL-6were still at high level at the third day after occurrence compared with the control group (P ＜ 0.05).And at the end of the first week,serum concentration of TNF-α and IL-1β were still higher than the control group (P＜0.05).Compared with the conventional treatment group,serum concentrations of TNF-α of Xuebijing group were significantly decreased from the third day to the seventh day,and the serum concentrations of IL-1β and IL-6 were significantly reduced on the third day (P＜0.05).Conclusion Xuebijing can reduce serum concentrations of TNF-α,IL-1β and IL-6 at the early stage of the AP course.Inhibiting the inflammation may be the molecular mechanisms through which Xuebijing treats AP.
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