重症急性胰腺炎Fas/FasL介导的胰腺细胞凋亡与Th1/Th2偏移的临床研究

目的]观察重症急性胰腺炎Fas/FasL介导的胰腺细胞凋亡与Th1/Th2偏移的关系.方法]将2012～2013年来我院治疗的急性胰腺炎患者40例分为重症胰腺炎（SAP）组和轻症胰腺炎（MAP）组,各20例.同时选取同时期来我院进行体检的健康人40例作为对照组,检测3组入院第1天以及观察组第3、5、7、10天患者血清中CD4＋T细胞计数、CD4＋细胞/CD8＋细胞、aFas、SCD4、IL-4、IFN-γ、IL-2、IL-10、IL-2/IL-10的变化.结果]CD4＋T细胞的减少与胰腺炎的严重程度有关,胰腺炎sCD4与sFas浓度之间存在明显相关性.SAP组和MAP组中IL-4、IL-10水平均较对照组明显升高,胰腺炎IL-4、IFN-γ浓度与胰腺炎严重程度存在明显相关性.结论]Th1/Th2细胞免疫漂移与急性胰腺炎有关,胰腺炎早期炎症反应占优势,之后抗炎反应占优势,与临床上急性胰腺炎发病过程相符,对于临床治疗胰腺炎有一定指导意义.

Clinical study on pancreas cell apoptosis and Th1/Th2 excursion mediated by Fas/FasL in severe acute pancreatitis

Objective]To observe the correlation of pancreas cell apoptosis and Thl/Th2 excursion me- diated by Fas/FasL in severe acute pancreatitis（SAP）. Methods]Forty acute pancreatitis patients of our hospital-from 2012 to 2013 were selected as the observation group（including 20 mild patients and 20 severe patients） ,and 40 healthy people were selected as the control group. Changes of CD4＋ T cells, CI）4 P/CD8~ cells counting,aFas,SCD4,IL-4,IFN-y,IL-2,IL-lO,IL-2/IL-lO in serum of the lst,3rd,Sth,Tth,10th day after the treatment were detected. Results]The decrease of CD4＋ T cells had correlation with severity of pancreati- tis, and there was significant correlation between pancreatitis sCD4 and sFas concentration. The levels of IL-4 and IL-10 of severe and mild pancreatitis were significantly higher than the control group. The concentration of IL-4 and IFN-7 had significant correlation with the severity of pancreatitis. Conclusion]The excurs＊on of Thl/Th2 cell immune had correlation with severe pancreatitis. In the early stage of pancreatitis~inflamma- tory reaction is the main manifestation, thereafter anti-inflammatory reaction is the main process, which conforms to the morbidity of SAP in clinic, providing guiding significance in clinical treatment.