丹参对急性胰腺炎患者血栓素A2／前列腺环素平衡和白介素-6、白介素-8水平的影响

目的探讨急性胰腺炎（AP）患者血栓素A2/前列腺环素（TXA2/PGI2）平衡和白细胞介素-6（IL-6）、IL-8的变化情况，及丹参治疗急性胰腺炎的作用机制。方法50例AP住院AP患者，包括重症急性胰腺炎（SAP）组13例、轻症急性胰腺炎（MAP）组37例，比较组间TXA2/PGI2平衡和IL-6、IL-8水平的差异。50例患者给予禁食、胃肠减压、生长抑素、质子泵抑制剂、抗感染及营养支持等治疗，并随机分为丹参治疗组（A组），在上述治疗基础上给予丹参注射液250ml，静脉点滴2次／d，7d为一个疗程）和一般治疗组（B组）。同时取健康体检者20例作为对照组（C组）。治疗前后取外周静脉血标本，测定TXA2、PGI2、IL-6、IL-8的含量。结果治疗前与C组比较，SAP组、MAP组患者外周血TXA：含量明显升高，PGI2含量降低，IL-6、IL-8含量升高（均P〈0．05）。与MAP组比较，SAP组TXA2、PGI2、IL-6、IL-8含量的异常变化更明显。治疗7d后，A组TXA2、PGI2含量与治疗前比较，已基本恢复正常（均P〈0．05），B组TXA2、PGI2含量与治疗前比较，无明显变化（均P〉0．05）；治疗7d后，A组、B组IL-6、IL-8含量均显著低于治疗前（均P〈0．05），与B组比较，A组下降更加明显（均P〈0．05）。结论AP患者存在TXA2/PGI2平衡紊乱和IL-6、IL-8异常升高现象。丹参治疗AP的机制可能是通过纠正血管活性物质分泌失衡，使血浆TXA2含量下降，PGI2含量上升，使TXA2/PGI2比值失衡恢复，并且抑制体内IL-6、IL-8的异常分泌，减轻AP患者全身炎症反应的水平，改善微循环障碍，最终使AP患者的病程得以逆转。

Effects of Salvia miltiorrhiza on interleukin(IL)-6 and IL-8 levels and thromboxane A2/ prostacyclin balance in patients with acute pancreatitis

Objective To observe the effects of Salvia miltiorrhiza （SM） on acute pancreatitis （AP） and to investigate the possible mechanism thereof. Methods Fifty AP patients, 15 with more severe clinical manifestations （SAP group） and 37 with relatively milder clinical manifestations （MAP group）, 38 males and 12 females, aged 35.2 （22-68）, were randomly divided into 2 equal treatment groups： Group A, given 250 ml SM injection by intravenous drip daily in 2 divided doses for 7 days in additiont to the conventional treatment , and Group B undergoing routine treatment： fasting, gastrointestinal decompression, growth chalone, proton pump inhibitor, anti-infection, and nutrition supply. Twenty sex- and age-matched healthy subjects were used as controls （Group C）. Before and 7 days after treatment peripheral venous blood samples were collected to detect the levels of thromboxane （TX） A2, prostacyclin （PGI2）, interleukin （IL）-6, and IL-8. Results Before treatment, the levels of TXA2, IL-6, and IL-8 of the AP patients, especially of the SAP group, were significantly higher than those of Group C, and the PGI2 levels of the AP patients, especially of the SAP group, were significantly lower than that of Group C （all P〈0.05）. Seven days after treatment, the levels of TXA2 and PGI2 in Group A almost resumed normal compared with the levels before treatment （all P〈0.05）, however, the TXA2 and PGI2 levels of Group B did not changed significantly, and the IL-6 and IL-8 levels of both Groups A and B, especially of Group A, decreased significantly （all P〈0.05）. Conclusion TXA2/PGI2 imbalance disorder and abnormal increase of IL-6 and IL-8 exist in AP. SM decreases the plasma TXA2 and increases the plasma PGI2, thus resuming the TXA2/PGI2 balance, and controls the abnormal secretion of IL-6 and IL-8, thus alleviating the overall inflammation response in AP patients.