还原型谷胱甘肽辅助治疗急性重症胰腺炎前后血浆Ghrelin CRP IL-8和TNF-α浓度的变化

摘要

目的 探讨还原型谷胱甘肽(GSH)辅助治疗急性坏死性胰腺炎前后血浆Ghrelin、CRP、IL-8和TNF-α浓度的变化.方法 100例急性坏死性胰腺炎患者随机分为GSH辅助治疗组(A组,n=50)和一般治疗组(B组,n=50).于入院时和治疗3天后进行APACHE-Ⅱ评分；并在入院时、治疗1天和3天后,观察血淀粉酶、血脂肪酶、血浆Ghrelin、CRP、IL-8和TNF-α浓度的变化.另外选择门诊体检健康成年人为对照组(C组,n=50).结果 GSH辅助治疗组和一般治疗组患者APACHE-Ⅱ评分在治疗3天后均明显下降,GSH辅助治疗组下降更明显(均P＜0.05).GSH辅助治疗组和一般治疗组患者血淀粉酶、血脂肪酶、血浆Ghrelin、CRP、IL-8和TNF-α浓度均进行性下降,且GSH辅助治疗组下降更明显(均P＜0.05).结论 GSH对SAP有辅助治疗作用.血浆Ghrelin、CRP、IL-8和TNF-α浓度与SAP病情严重程度相关.%Objective To investigate the effect of glutathione (GSH) on serum Ghrelin, CRP, IL-8 and TNF- α level in patients with severe acute pancreatitis. Methods 100 patients with SAP were randomly divided into 2 groups, GSH treatment group and normal treatment group, 50 patients in each. 50 health adults were included as control group. On day 0 and day 3, APACHE- II score was evaluated in SAP patients. On day 0, day 1 and day 3, serum amylase, li-pase, Ghrelin, CRP, IL-8 and TNF- α level were documented. Results On day 0, no significant difference on APACHE-II score was observed between GSH treatment goup and normal treatment group. However, on day 3, a signifcant difference was showed between GLY treatment goup and normal treatment group. On day 0, no significant difference on serum amylase, lipase, Ghrelin, CRP, IL-8 and TNF- α level were identified between GSH treatment goup and normal treatment group. However, on day 1 and day 3, serum amylase, lipase, Ghrelin, CRP, IL-8 and TNF- α level in normal treatment group were higher than in GSH treatment group. Otherwise, serum amylase, lipase, Ghrelin, CRP, IL-8 and TNF- α level in patients with SAP were noticeably higher than in control group. Conclusion Glutathione can be used as an effective drug in SAP. Meanwhile, serum Ghrelin, CRP, IL-8 and TNF- α level were sensitive markers in SAP induced inflammation.