重症急性胰腺炎早期血管活性物质的变化及意义
Changes of the Vaso-active Substances in the Early Phase of Severe Acute Pancreatitis and Its Significance
王鑫 1王营1
作者信息
- 1. 徐州医学院附属医院消化内科,221006
- 折叠
摘要
目的:探讨内皮素(ET)与降钙素基因相关肽(CGRP)及一氧化氮(NO)在重症急性胰腺炎(SAP)早期发病中的作用及临床意义.方法:采用放射免疫分析及硝酸还原酶法测定急性发病期(24h~48h)重症急性胰腺炎(SAP)17例,轻症急性胰腺炎(MAP)35例和正常对照组(NC)30例的血浆ET与CGRP及血清NO的含量.Imrie评分＞3分,APACHEⅡ评分≥8分者为SAP.结果:SAP患者Imrie评分和APACHEⅡ评分明显高于MAP患者(P<0.05,P<0.01).SAP患者血浆ET水平明显增高,MAP患者血浆ET水平明显降低,两组之间比较以及与NC组比较具有非常显著差异(P<0.001).SAP患者血浆CGRP水平无明显变化(P>0.05).MAP患者血浆CGRP水平明显增高(P<0.001).AP患者血清NO水平显著降低,SAP与MAP两组患者NO比较具有非常显著差异(P<0.001).SAP患者ET/CGRP及ET/NO比值与MAP患者及NC组比较明显增高(P<0.01);MAP患者ET/CGRP比值与NC组比较明显降低(P<0.05),MAP患者ET/NO比值与NC组比较无显著差异(P>0.05).结论:ET或与SAP胰腺组织的病理性出血和坏死具有密切关系,微循环障碍对胰腺组织具有内源性损伤作用.ET/CGRP及ET/NO比值能较好地反映AP患者病情轻重,可作为评价其预后的指标.
Abstract
Objective To evaluate the effects and clinical significance of endothelin (ET), calcitonin-gene-related peptide (CGRF) and nitric oxide (NO) in the early phase of acute pancreatitis (AP) .Methods The contents of ET, CGRP and NO were measured by radioinununoassay and nitrate reductase in the blood samples from 17 patients with severe acute pancreatitis ( SAP),35 patients with mild acute pancreatitis (MAP) and 30 normal controls (NC). SAP: Imrie' score ＞3, APACHE Ⅱ≥8 .Results The score of Imrie and APACHE II in the patients of SAP were obviously higher than those in MAP (P＜0.05,P＜0.01). ET level increased significantly in SAP, while that decreased obviously in MAP; NO levels dropped significantly in AP, there were significant differences (P＜0.001) between SAP and MAP. CGRP level increased markedly(P＜0.001) in HAP . CGRP level had no statistic different significance (P＞0.05) in SAP as compared with NC. The ratios of ET/CGRPand ET/NO in SAP were higher than those in MAP and NC (P＜0.01). The ratios of ET/CGRP and ET/NO in MAP were reduced or unchanged as compared with NC (P＜0.05, P ＞0.05). Conclusion ET may have close relationship with the pathological haemorrhage and necrosis in pancreas tissue in SAP. Besides, may participate the disturbance of microciiculation CGRP and NO may have a beneficial influence on MAP by improves the microcirculation within the pancreatic gland . The ratios of ET/CGRP and ET/NO may serve as the sign to judge prognosis in the early phase of AP.
关键词
急性胰腺炎/内皮素/降钙素基因相关肽/一氧化氮Key words
acute pancreatitis/ET/CGRP/NO引用本文复制引用
出版年
2013
NETL
NSTL
维普
万方数据