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[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。
[Objective] To observe the relationship between Fas / FasL-mediated pancreatic cell apoptosis and Th1 / Th2 shift in severe acute pancreatitis. [Methods] Forty patients with acute pancreatitis treated in our hospital from 2012 to 2013 were divided into severe pancreatitis (SAP) group and mild pancreatitis (MAP) group, 20 cases each. At the same time, we selected 40 healthy people who were in our hospital during the same period as the control group to test the serum CD4 + T cell count, CD4 + cell / CD8 + AFas, SCD4, IL-4, IFN-γ, IL-2, IL-10, IL-2 / IL-10. [Results] The decrease of CD4 + T cells was related to the severity of pancreatitis. There was a clear correlation between the concentration of sCD4 and sFas in pancreatitis. The levels of IL-4 and IL-10 in SAP group and MAP group were significantly higher than those in control group. There was a significant correlation between the concentrations of IL-4 and IFN-γ in pancreatitis and the severity of pancreatitis. [Conclusion] The immune drift of Th1 / Th2 cells is related to acute pancreatitis. The early inflammatory response of pancreatitis is predominant, and then the anti-inflammatory response is predominant. It is consistent with the clinical course of acute pancreatitis, which is of guiding significance for clinical treatment of pancreatitis.