【摘要】 目的　探讨促炎和抗炎细胞因子及其平衡与重症胰腺炎 (SAP)的关系。方法　 2 6例 SAP病人分为血液滤过组和对照组。测定血清内促炎细胞因子 TNFα、IL - 1β、IL - 8、s IL - 2 R及抗炎细胞因子 IL - 2、IL - 10的含量 ,观测 APACHE 评分、CT积分和体液细菌培养及临床症状的变化 ,以观察促炎和抗炎细胞因子与疾病严重度、胰腺坏死、机体免疫力及腹痛的关系。结果　 A-PACHE 及 CT积分显著降低和腹痛 (P<0 .0 5 )时间显著缩短 ;体液细菌培养时间显著延迟和阳性率降低 (P<.0 0 5 )。血滤组的促炎细胞因子较对照组显著降低 ,而抗炎细胞因子却显著升高 (P<0 .0 5 )。结论　促炎和抗炎细胞因子与重症胰腺炎的病理生理变化密切相关 ,且两者的相对变化较两者的绝对变化更为重要更多还原

【Abstract】 Objective To investigate the role of pro inflammatory cytokines and antiinflammatory cytokines in the pathogenesis of severe acute pancreatitis.Methods Twenty six patients with severe acute pancreatitis were divided into hemofiltration(HF,16pts) and nonhemofiltration group(NHF,10pts).In order to observe the relationship between pro inflammatory cytokines as well as anti inflammatory cytokines and severity,pancreatic necrosis,immunity and abdominal pain,levels of pro inflammatory cytokines(TNFα、IL-1β、IL-8、sIL-2R)and anti inflammatory cytokines(IL-2、IL-10)in serum were determined,scores of APACHEⅡ, CT and culture of bacteria as well as abdominal pain were done simultaneously.Results Scores of APACHEⅡ and CT were decreased significantly(P<0.05);Duration for abdominal pain was significantly shorted(P<0.05).Duration for culture of bacteria in body liquid were prolonged and positivity rate was decreased significantly(P<0.05).The levels of pro inflammatory cytokines in hemofiltration group were much lower than those of non hemofiltration group,but The of anti inflammatory cytokines were increased significantly(P<0.05).Conclusions Pathophysiogical changes of severe acute pancreatitis are closely related to pro inflammatory cytokines and anti inflammatory cytokines and relative levels of pro inflammatory cytokines and anti inflammatory cytokines in SAP the is more important than that of their absolute levels.更多还原