吲哚美辛对内镜下逆行胆胰管造影术后外周血辅助性T细胞的影响

  目的  探讨吲哚美辛栓纳肛对预防内镜下逆行胆胰管造影术(ERCP)后胰腺炎(PEP)可能的细胞学机制。  方法  选择2017年3-10月在蚌埠医学院第一附属医院消化内科住院并拟行ERCP术的患者40例, 按随机数字表法随机分为观察组和对照组, 每组20例, 分别检测2组患者ERCP术前及术后12 h外周静脉血调节性T细胞(Treg)、辅助性T细胞17型(Th17)及Treg/Th17值。  结果  对照组: 术前Treg、Th17、Treg/Th17分别为2.94(1.52, 3.71)%、1.42(0.87, 4.47)%、1.57(0.69, 2.88), 术后分别为1.92(1.22, 3.25)%、2.02(1.12, 4.93)%、0.77(0.37, 1.75), 术前术后比较差异均有统计学意义。观察组: 术前Treg、Th17、Treg/Th17分别为1.57(0.97, 2.37)%、1.92(1.27, 3.05)%、0.74(0.39, 2.28);术后分别为1.63(1.03, 1.86)%、2.26(1.36, 3.65)%、0.65(0.38, 1.64), 术前术后比较差异均无统计学意义。2组间除术前Treg差异有统计学意义外(Z=-2.259, P=0.024), 其余指标差异均无统计学意义。  结论  吲哚美辛栓纳肛预防ERCP术后PEP可能机制是维持Treg、Th17细胞免疫平衡, 使ERCP术后早期的炎症反应得到控制。 

Effect of indomethacin on helper T cells in peripheral blood after endoscopic retrograde cholangiopancreatography

  Objective  To investigate the possible cytological mechanism of indomethacin suppository in the prevention of pancreatitis (PEP) after endoscopic retrograde cholangiopancreatography (ERCP).  Methods  Forty patients who were hospitalised in the Department of Gastroenterology of the First Affiliated Hospital of Bengbu Medical College from March 2017 to October 2017 and planned to undergo ERCP were randomly divided into the observation group and control group, with 20 cases in each group.The peripheral venous blood Treg, Th17 and Treg/Th17 values of the two groups were measured before and 12 h after ERCP.  Results  In the control group, the preoperative Treg, Th17 and Treg/Th17 values were 2.94(1.52, 3.71)%, 1.42(0.87, 4.47)% and 1.57(0.69, 2.88), and the postoperative values were 1.92(1.22, 3.25)%, 2.02(1.12, 4.93)% and 0.77(0.37, 1.75), respectively.There were significant differences in the preoperative and postoperative changes.In the observation group, the preoperative Treg, Th17 and Treg/Th17 values were 1.57(0.97, 2.37)%, 1.92(1.27, 3.05)% and 0.74(0.39, 2.28), and the postoperative values were 1.63(1.03, 1.86)%, 2.26(1.36, 3.65)% and 0.65(0.38, 1.64), respectively.There was no significant difference between the preoperative and postoperative changes.There was no significant difference in other indexes between the two groups except for the preoperative Treg difference (Z=-2.259, P=0.024).  Conclusion  The possible mechanism of indomethacin suppository in preventing PEP after ERCP is to maintain the immune balance of Treg and Th17 cells and control the early inflammatory response after ERCP.