摘要
目的分析老年重症急性胰腺炎继发性感染患者的免疫状态。方法入选105例老年重症急性胰腺炎患者，根据是否合并继发性感染分为对照组（47例）和感染组（58例）。在确诊发生继发性感染3d内用流式细胞仪检测血清CD4＋或CD8＋T细胞的百分率，酶联免疫法测定血清肿瘤坏死因子-α（TNF-α）、白介素-6（ID6）、白介素4（IL-4）和白介素-10（IL-10）的浓度。结果58例患者出现继发性感染，发病3d内感染组血清TNF-α、IL-6、IL-4、IL-10、CD4＋T细胞、CD8＋T细胞和CD4＋／CD8＋分别为（81．3±5．5）ng／L、（141．2±13．7）ng／L、（61．1±7．4）ng／L、（153．8±15．2）ng／L、（43．5±5．5）%、（20．7±2．9）％、2．4±0．3，与对照组（50．8±4．7）ng／L、（81．4±11．7）ng／L、（30.8±7．8）ng／L、（100．3±13．8）ng／L、（31．6±4．6）％、（29．7±3．5）％、1．1±0．4比较升高（t=730、6．51、4．87、4．52、2．88、3．41、4．26，均P〈0．05）；发病28d感染组患者血清TNF-α、IL-6、IL-4、IL-10、CD4＋T细胞、CD8＋T细胞和CD4＋／CD8＋分别为（29．3±5．8）ng／L、（51．7±7．9）ng／L、（33.8±5．1）ng／L、（82．6±9．5）ng／L、（22．1±3．3）％、（47．1±4．3）％、0．6±0．3，与对照组（44．4±5.5）ng／L、（82．2±7．1）ng／L、（65．3±5．5）ng／L、（109．1±9．5）ng／L、（40．5±2．7）％、（33．4±4.5）％、1．8±0．4比较下降（t=3．26、4．93、7．32、3．43、7．41、3．81、4．33，均P〈0．05）。结论老年重症急性胰腺炎合并继发性感染患者存在早期过度炎性反应和晚期免疫功能损害。
Objective To Analyze the immunity to secondary infection in the elderly with severe acute pancreatitis. Methods Totally 105 old patients were included in the present study. The ratio of CD4＋ to CD8＋, and serum levels of tumor necrosis factor-α （TNF-α）, interleukin-6 （IL-6）, interleukin-10 （IL-10）, and interleukin-4 （IL-4） were determined by flow cytometer analysis or ELISA within 3 days after diagnosis of secondary infection. Results Among 105 old patients, 58 cases experienced secondary infection. At 3th day after severe acute panereatitis, the levels of TNF-α, IL-6, IL-4, IL-10, CD4＋,CD8＋ and CD4＋/ CD8＋ were （81.3±5.5）ng/L, （141.2±13.7）ng/L, （61.1±7.4）ng/L, （153.8±15.2）ng/L, （43.5±5.5）%, （20.7±2.9）% and （2.4±0.3） in infection group, as compared with those of （50. 8±4. 7）ng/L, （81, 4±11.7）ng/L, （30.8±7.8）ng/ L, （100.3±13.8）ng/L, （31.6±4.6）ng/L, （29.7±3.5） and （1.1±0.4） in control group, respectively, with statistically significant differences between the two groups （ t= 7.30, 6.51, 4.87, 4.52, 2.88, 3.41, 4.26,all P〈0.05）. At 28th day after SAP, the levels of TNF-α, IL-6, IL-4, IL- 10, CD4＋,CD8＋ and CD4＋/CD8＋ were （29.3±5.8）ng/L, （51.7±7.9）ng/L, （33.8±5.1）ng/L, （82.6±9.5）ng/L, （22.1±3.3）%, （47.1±4.3）% and （0.6±0.3） in infection group, as compared with those of （44.4±5.5）ng/L, （82.2±7.1）ng/L, （65.3±5.5）ng/L, （109.1±9.5）ng/L, （40.5 ±2.7）ng/L, （33.4±4.5）ng/L and （1.8±0.4） in control group, respectively, showing statistically significant differences between the two groups（t=3.26, 4.93, 7.32,3.43, 7.41, 3.81, 4.33,all P〈0.05）. Conclusions An early excessive immune response and subsequent immune injury is closely related to secondary severe acute pancreatitis.
出处
《中华老年医学杂志》
CAS
CSCD
北大核心
2014年第6期610-612,共3页
Chinese Journal of Geriatrics
关键词
胰腺炎
免疫因子类
感染
Pancreatitis
Immunologic factors
Infection
