血清白细胞介素10、白细胞介素18在急性胰腺炎中的变化及意义

目的 探讨促炎性细胞因子白细胞介素18(IL-18)与抗炎性细胞因子白细胞介素10(IL-10)在急性胰腺炎中的变化及意义.方法 对10例健康志愿者(对照组)、10例急性水肿性胰腺炎(MAP)组、10例急性出血坏死性胰腺炎(SAP)组,分别于第1、2、5、10天进行APACHEII评分,血清TNF-α、IL-10、IL-18的测定,并对第1天IL-18与APACHEII评分,血清TNF-α、IL-10做相关性分析.结果 MAP组与SAP组APACHEII评分,血清TNF-α、IL-10、IL-18水平显著高于对照组(P＜0.01).发病初期MAP组血清IL-10水平高于SAP组(P＜0.01).SAP组血清TNF-α、IL-18水平高于MAP组(P＜0.01),第1天IL-18水平与APACHEII评分,血清TNF-α水平呈正相关关系(r=0.82,P＜0.01;r=0.74,P＜0.01),与血清IL-10呈负相关关系(r=-0.58,P≤0.01).结论 促炎性细胞因子IL-18与抗炎性细胞因子IL-10参与了急性胰腺炎的炎症反应过程,可以预测急性胰腺炎的严重程度.

Changes and significance of serum interleukin-10 and interleukin-18 in acute pancreatitis

Objective To investigate the changes and significance of pro-inflammatory cytokine interleukin-18 (IL-18) and anti-inflammatory cytokine interleukin-10 (IL-10) in acute pancreatitis (AP). Methods Serum TNF-a, IL-10 and IL-18 were determined quantitatively in 10 healthy persons, 10 MAP patients and 10 severe acute pancreatitis (SAP), patients, meanwhile, APACHEII score was made on day 1, 2, 5 and 10. The correlation between IL-18 and APACHEII score, TNF-a and IL-10 were analyzed on day 1. Results In both MAP and SAP, APACHEII score, serum TNF-a, IL-10 and IL-18 were significantly higher than those in control group (P<0.01). In MAP group, serum IL-10 was significantly higher than it in SAP group in early stage of AP. In SAP group, APACHEII score, serum TNF-a and IL-18 were significantly higher than those in MAP group (P<0.01, P<0.05). Significant correlations, calculated for day 1, were found between IL-18 and APACHEII score (r =0.82, P<0.01), between IL-18 and TNF-a (r =0.74, P<0.01) and between IL-18 and IL-10 (r = -0.58, P <0.01). Conclusions IL-10 and IL-18 play important roles in the development of acute pancreatitis, and they may be valuable indexes to predict the severity of AP.