【摘要】 目的通过研究急性梗阻性化脓性胆管炎(AOSC)患者胆汁及血清中肿瘤坏死因子(TNF)α和白细胞介素(IL)-6的含量,探讨二者在此病中的表达水平及临床意义。方法经内镜逆行胰胆管造影(ERCP)检查确诊AOSC 30例,采用双抗体夹心酶联免疫吸附测定(ELISA)试剂盒检测胆汁和血清中TNFα、IL-6的含量,同时与40例非AOSC病例对照。并于术后第4 d经鼻胆管引流测定30例AOSC患者胆汁中TNFα、IL-6的含量。结果 AOSC组术中胆汁中TNFα、IL-6含量分别为(179.25±26.50)、(207.00±42.05)pg/ml,血清中TNFα、IL-6含量为(189.14±28.89)、(420.18±89.04)pg/ml。对照组胆汁中TNFα、IL-6含量为(4.02±2.17)、(7.48±3.89)pg/ml,血清中TNFα、IL-6含量为(8.16±2.29)、(14.92±4.73)pg/ml。AOSC组胆汁和血清TNFα、IL-6含量高于对照组(P<0.01),AOSC组患者术后第4 d与术中胆汁TNFα、IL-6比较明显下降(P<0.01)。结论 AOSC组患者胆汁和血清中TNFα、IL-6含量高于对照组,TNFα、IL-6可能参与了AOSC的病理生理过程且可作为诊断AOSC的参考指标。更多还原

【Abstract】 Objective To investigate the dynamic changes in tumor necrosis factor-alpha(TNF α) and interleukin-6(IL-6) levels in bile and serum of patients with acute obstructive suppurative cholangitis(AOSC) and evaluate the clinical significance of these factors.Methods Thirty patients diagnosed with AOSC by endoscopic retrograde cholangiopancreatogram(ERCP) and 40 patients classified as non-AOSC by ERCP(controls) were enrolled in the study.The double-antibody sandwich enzyme-linked immunosorbent assay was used to measure TNF α and IL-6 content in bile and serum samples taken at study enrollment(baseline,for AOSC and non-AOSC groups) and four days after surgery(for AOSC group).Results The AOSC group showed significantly higher baseline content of TNF α(bile: 179.25±26.50 pg/ml,serum: 189.14±28.89 pg/ml) and IL-6(bile: 207±42.05 pg/ml,serum: 420.18±89.04 pg/ml) than the control group(TNF α bile: 4.02±2.17 pg/ml,serum: 8.16±2.29 pg/ml;IL-6 bile: 7.48±3.89 pg/ml,serum: 14.92±4.73 pg/ml)(all P<0.01).In addition,the AOSC group showed significantly reduced levels of TNF α and IL-6 in bile on the fourth day after surgery(vs.baseline,P<0.01).Conclusion AOSC patients have enhanced levels of TNF α and IL-6 in both serum and bile,suggesting that these two inflammation-related cytokine factors may be involved in the disease pathophysiology.Future studies should investigate whether TNF α and IL-6 can be used as diagnostic markers of AOSC.更多还原