急性胰腺炎早期患者IL-10、IL-6变化的临床意义

【目的】了解急性胰腺炎 (AP)早期患者IL 10、IL 6的变化及临床意义。【方法】分别在AP病人入院后d1和d3 采血 ,回顾性分析其IL 6、IL 10的早期变化并与健康献血人群比较。【结果】AP患者血浆IL 10阳性检测率在入院d1为 4 4 .6 %、d3 为 2 4 .4 % ,正常人群无阳性结果 (P <0 .0 5 )。血浆IL 6入院d1SAP组血浆IL 6浓度明显高于MAP组及正常对照组 (P <0 .0 1) ,MAP组与正常组IL 6浓度也有显著差异 (P <0 .0 1) ,最佳截断值为 10 5 pg/ml,预测SAP的敏感性 84 .6 2 % ,特异性 94 .12 % ,阳性预断值 93.5 2 % ,阴性预断值 85 .95 % ,可用度为 78.73% ;入院d3 SAP组血浆IL 6浓度仍明显高于MAP组和正常组 (P <0 .0 1) ,MAP组与正常组相比差异无显著性 (P >0 .0 5 )。【结论】IL 10在正常人中一般不能检测出 ,在AP时升高 ;SAP早期IL 6浓度明显升高 ,检测IL 6可能对于早期鉴诊有一定的意义 ,其监测SAP的敏感性、特异性较高 ,且稳定性较好 ,可作为其临床诊断参考指标之一

Clinical Significance of Interleukin-6 and Interleukin-10 Changes in Patients with Early Stage of Acute Pancreatitis

ObjectiveTo understand the changes of plasma interleukin-6 (IL-6) and interleukin-10(IL-10) levels and their clinical significance in patients at early stage of acute pancreatitis (AP).The peripheral blood samples were drawn from AP patients in the first and third day after admission, their early changes of IL-6 and IL-10 were analyzed and compared with the healthy blood donors retrospectively.The positive detection rates of IL-10 in the AP patients at 1st and 3rd day of admission were 44.6% and 24.4% respectively, obviously higher than those in the normal controls (P<0.05).At the 1st day of admission, the plasma levels of IL-6 in severe acute pancreatitis (SAP) group significantly increased as compared with those in mild acute pancreatitis (MAP) group and the normal controls (P<0.01) ; whereas the plasma levels of IL-6 in MAP group were also distinctly higher than those in the normal controls (P<0.01).The optimal cutoff value of IL-6 was 105 pg/ml,its sensitivity and specificity of predictive detection were 84.62% and 94.12%, with a positive predictive value of 93.52%, negative predictive value of 85.95% and diagnostic availability of 78.73%; at the 3rd day of admission, the plasma levels of IL-6 in SAP group were markedly higher than those in MAP group and the normal controls (P<0.01),but no significant differences in IL-6 were found between MAP and control groups (P>0.05).[Conclusion]During the early stage of AP, detection of plasma IL-6 level is a valuable and trustworthy index for diagnosis and monitoring of SAP attack, it may also serve as a highly sensitive and specific marker of following-up.