IL-33及sST2在急性胰腺炎合并急性肾损伤中的表达变化和作用

发布时间：2018-03-25 08:22

本文选题：白介素33　切入点：瘤变抑制因子2　出处：《山西医科大学》2017年硕士论文

【摘要】：目的:检测急性胰腺炎患者及其合并肾损伤时血浆中IL-33/s ST2的表达情况,探讨IL-33/s ST2与急性胰腺炎病情严重程度的关系,并且分析IL-33和s ST2在急性胰腺炎合并急性肾损伤机制中所发挥的促炎作用,进而可以为我们在临床上对于急性胰腺炎合并肾损伤的早期诊断和早期治疗从分子学角度提供帮助。方法:临床收集山西医科大学第二医院普外科、山西省人民医院消化科2016年01月至2016年12月收治并诊断为急性胰腺炎(acute pancreatitis,AP)的60例患者当作实验组,而且依据AP患者有否合并有急性肾损伤(acute kidney injury,AKI),将实验组分为AKI组和非AKI组,其中非AKI组52例,AKI组8例;选择同期的健康者30例来作为对照组。采集所有入选实验组非AKI组患者入院第1天,AKI组入院第1、3、7、14天的晨起空腹血标本和对照组的随机晨起空腹血标本,然后运用酶联免疫吸附测定法(ELISA法)来检测所有血标本中IL-33和s ST2的值以及其他相关的血清生化指标,讨论各指标间的相互关系并分析他们的临床意义。结果:1.在非AKI组中,患者血清中IL-33的平均水平为:(137.5±18.5)pg/ml;在AKI组中,患者血清中IL-33的平均水平为:(278.3±23.4)pg/ml;在正常健康对照组中,血清中IL-33的平均水平为:(42.7±20.1)pg/ml。急性胰腺炎(AP)患者的血清中IL-33的表达水平较正常健康对照者升高,并且各个组之间均有差异,且其差异有统计学意义((49)0.01)。2.在非AKI组中,患者血清中s ST2的平均水平为:(123.8±20.3)pg/ml;在AKI组中,患者血清中s ST2的平均水平为:(212.7±19.5)pg/ml;在正常健康对照组中,血清中s ST2的平均水平为:(64.9±21.7)pg/ml。急性胰腺炎(AP)患者血清中s ST2的表达水平较正常健康对照组升高,并且各个组之间均有差异,且其差异有统计学意义((49)0.05)。3.血清中IL-33和s ST2的表达水平呈正相关(r=0.805,(49)0.01)。4.在急性胰腺炎合并AKI患者血清中IL-33、s ST2、Cr的水平在入院第3天水平升高,且与入院第1天的水平有差异,其差异有统计学意义((49)0.05);入院第7天IL-33、s ST2、Cr的水平较第3天降低,与第1天的差异无统计学意义;入院第14天IL-33、s ST2、Cr的水平较第7天降低,与第1天、第3天的水平有差异,其差异有统计学意义((49)0.05)。5.在急性在急性胰腺炎合并AKI患者血清中IL-33、s ST2、Cr的水平在入院第3天水平升高,第7天、第14天水平下降,且IL-33的下降较s ST2、Cr明显。结论:对于急性胰腺炎合并急性肾损伤患者,其血清中IL-33及s ST2的表达水平可以更好的评估肾功能。IL-33在急性胰腺炎合并肾损伤的炎症机制中发挥有一定的促进作用,s ST2在急性胰腺炎合并肾损伤的炎症机制中起保护作用。
[Abstract]:Objective: to investigate the expression of IL-33/s ST2 in plasma of patients with acute pancreatitis and its associated renal injury, and to explore the relationship between IL-33/s ST2 and severity of acute pancreatitis. The role of IL-33 and s ST2 in acute pancreatitis with acute renal injury was analyzed. It may be helpful to us in the early diagnosis and early treatment of acute pancreatitis with renal injury from a molecular perspective. Methods: general surgery of the second Hospital of Shanxi Medical University. From January 2016 to December 2016, the Department of Digestive Medicine of Shanxi Provincial people's Hospital treated 60 patients with acute pancreatitis as experimental group, and divided the experimental group into AKI group and non-#en2# group according to whether the AP patients had acute kidney injuryAkei. Among them, 52 cases were non-#en0# group and 8 cases were non-AKI group. 30 healthy subjects were selected as control group. Fasting blood samples were collected from the first day of admission to the AKI group on the first day of admission and from day 1 to day 14 in the control group. Then Elisa was used to detect the values of IL-33 and s ST2 in all blood samples, as well as other related serum biochemical indexes, to discuss the relationship between the indexes and to analyze their clinical significance. Results: 1. In the non AKI group, The average level of IL-33 in patients' serum was 137.5 卤18.5g / ml, in the AKI group, the average level of IL-33 was 278.3 卤23.4g / ml. In the normal control group, the average level of IL-33 was 278.3 卤23.4g / ml. The average level of IL-33 in serum was 42.7 卤20.1g / ml. The expression of IL-33 in serum of patients with acute pancreatitis was higher than that of normal controls, and there were significant differences among different groups, and the difference was statistically significant. The average level of s ST2 in patients' serum was 123.8 卤20.3 g / ml; in AKI group, the average level of s ST2 was 212.7 卤19.5pg / ml; in the normal control group, the average level of s ST2 was 212.7 卤19.5pg / ml; in the normal control group, the average level of s ST2 was 212.7 卤19.5g / ml. The average level of s ST2 in serum was 64.9 卤21.7 PG / ml. The expression of s ST2 in the serum of patients with acute pancreatitis was higher than that of the normal control group, and there were differences between the two groups. There was a positive correlation between the expression of IL-33 and s ST2 in the serum of patients with acute pancreatitis complicated with AKI, and the level of IL-33 / S ST2Cr increased on the third day of admission, and there was a difference between the levels on the third day of admission and the level of s ST2 on the first day of admission, and there was a positive correlation between the expression of IL-33 and s ST2 in the serum of patients with acute pancreatitis complicated with AKI. The difference was statistically significant (P < 0. 05), the level of IL-33N ST2Cr on the 7th day of admission was lower than that on the third day, but there was no significant difference between the first day and the first day, and on the 14th day of admission, the level of IL-33 + s ST2ncr was lower than that on the 7th day, which was different from that of the first day and the third day. There was a significant difference in serum levels of IL-33 and ST2nCr in patients with acute pancreatitis complicated with AKI on the 3rd day of admission, and decreased on the 7th and 14th day after admission, and there was a significant difference between the two groups in the serum levels of IL-33 and ST2ncr in the patients with acute pancreatitis complicated with AKI, the difference was statistically significant (P < 0.05). The decrease of IL-33 was significantly higher than that of sST2Cr. Conclusion: in patients with acute pancreatitis complicated with acute renal injury, The expression of IL-33 and s ST2 in serum can better evaluate the role of IL-33 in the inflammatory mechanism of acute pancreatitis complicated with renal injury. The expression of s ST2 may play a protective role in the inflammatory mechanism of acute pancreatitis complicated with renal injury.
【学位授予单位】：山西医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R576;R692

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