急性胰腺炎患者血清HMGB1、TLR4、TLR9、DAO水平变化及意义
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摘要
目的观察急性胰腺炎(AP)患者血清高迁移率族蛋白1(HMGB1)、TOLL样受体(TLR) 4、TLR9、二胺氧化酶(DAO)水平变化,并探讨其临床意义。方法选择起病24 h内AP患者59例,根据病情分为轻型AP(MAP)组26例、中度重症AP(MSAP)组17例、重症AP(SAP)组16例,同期选择健康体检者20例作为对照组。于入院24、48、72 h采用双抗体夹心免疫发光法测定血清HMGB1、TLR4、TLR9、白细胞介素6 (IL-6)、肿瘤坏死因子α(TNF-α)、DAO。结果入院24、48 h,AP各组血清HMGB1、TLR4、TLR9、DAO、TNF-α、IL-6水平均高于对照组(P均<0. 05);入院72 h,MAP组血清HMGB1、TLR4、TLR9、DAO水平与对照组比较差异无统计学意义(P均> 0. 05),但MSAP组、SAP组以上指标仍高于对照组(P均<0. 05)。AP各组血清TNF-α、IL-6水平在入院24 h达峰值,血清HMGB1、TLR4、TLR9、DAO水平在入院48 h达峰值。SAP组各时间点血清HMGB1、TLR4、TLR9、TNF-α、IL-6、DAO水平均高于MSAP组与MAP组(P均<0. 05)。AP患者血清HMGB1水平与DAO呈正相关(r=0. 942,P <0. 05)。结论血清HMGB1、TLR4、TLR9、DAO水平可反映AP患者病情变化,HMGB1与DAO可能协同参与肠黏膜屏障损伤。
Objective To observe the changes of serum high mobility group box 1( HMGB1),Toll-like receptor( TLR) 4,TLR9,and diamine oxidase( DAO) levels in patients with acute pancreatitis( AP) and to explore its clinical significance. Methods We collected 59 patients with AP within 24 hours of onset. According to the condition,we divided them into the MAP group of 26 cases,MSAP group of 17 cases,SAP group of 16 cases,and meanwhile,20 healthy physical examination cases were selected as the control group. Serum HMGB1,TLR4,TLR9,interleukin-6( IL-6),tumor necrosis factor-alpha( TNF-α) and DAO were measured by double antibody sandwich immunoluminescence( ELISA) at 24,48 and 72 h after admission. Results At 24 and 48 h after admission,the levels of serum HMGB1,TLR4,TLR9,DAO,TNF-α,and IL-6 in the AP group were higher than those in the control group( all P < 0. 05). After admission for 72 h,there was no significant difference in the levels of HMGB1,TLR4,TLR9 and DAO between the MAP group and control group( all P > 0. 05),but the above indexes in the MSAP group and SAP group were still higher than those in the control group( all P < 0. 05). Serum levels of TNF-α and IL-6 in the AP group reached peak at 24 h after admission,but HMGB1,TLR4,TLR9,and DAO reached peaked at 48 h after admission. The serum levels of HMGB1,TLR4,TLR9,TNF-α,IL-6,and DAO in the SAP group were higher than those in the MSAP group and MAP group( all P < 0. 05). The level of HMGB1 was positively correlated with DAO in patients with AP( r = 0. 942,P < 0. 05). Conclusion The levels of serum HMGB1,TLR4,TLR9,and DAO can reflect the changes of AP patients' conditions,and both HMGB1 and DAO may be involved in intestinal mucosal barrier damage.
Objective To observe the changes of serum high mobility group box 1( HMGB1),Toll-like receptor( TLR) 4,TLR9,and diamine oxidase( DAO) levels in patients with acute pancreatitis( AP) and to explore its clinical significance. Methods We collected 59 patients with AP within 24 hours of onset. According to the condition,we divided them into the MAP group of 26 cases,MSAP group of 17 cases,SAP group of 16 cases,and meanwhile,20 healthy physical examination cases were selected as the control group. Serum HMGB1,TLR4,TLR9,interleukin-6( IL-6),tumor necrosis factor-alpha( TNF-α) and DAO were measured by double antibody sandwich immunoluminescence( ELISA) at 24,48 and 72 h after admission. Results At 24 and 48 h after admission,the levels of serum HMGB1,TLR4,TLR9,DAO,TNF-α,and IL-6 in the AP group were higher than those in the control group( all P < 0. 05). After admission for 72 h,there was no significant difference in the levels of HMGB1,TLR4,TLR9 and DAO between the MAP group and control group( all P > 0. 05),but the above indexes in the MSAP group and SAP group were still higher than those in the control group( all P < 0. 05). Serum levels of TNF-α and IL-6 in the AP group reached peak at 24 h after admission,but HMGB1,TLR4,TLR9,and DAO reached peaked at 48 h after admission. The serum levels of HMGB1,TLR4,TLR9,TNF-α,IL-6,and DAO in the SAP group were higher than those in the MSAP group and MAP group( all P < 0. 05). The level of HMGB1 was positively correlated with DAO in patients with AP( r = 0. 942,P < 0. 05). Conclusion The levels of serum HMGB1,TLR4,TLR9,and DAO can reflect the changes of AP patients' conditions,and both HMGB1 and DAO may be involved in intestinal mucosal barrier damage.
引文
[1]中华医学会消化病学分会胰腺疾病学组.中国急性胰腺炎诊治指南(2013年,上海)[J].中华消化杂志,2013,33(4):217-222.
[2]Banks PA,Bollen TL,Dervenis C,et al. Classification of acute pancreatitis-2012:revision of the Atlanta classification and definitions by international consensus[J]. Gut,2013,62(1):102-111.
[3]Harris HE,Andersson U,Pisetsky DS. HMGB1:a multifunctional alarmin driving autoimmune and inflammatory disease[J]. Nat Rev Rheu-matol,2012,8(4):195-202.
[4]Lin Y,Lin LJ,Jin Y,et al. Correlation between serum levels of high mobility group box-1 protein and pancreatitis:a meta-analysis[J]. Biomed Res Int,2015,2015:430185.
[5]何志捷,植耀炜,黄超泰,等.血清二胺氧化酶、D-乳酸和细菌内毒素在重症患者肠道功能评估中的作用[J].岭南现代临床外科,2017,17(4):664-666.
[6]米亚英,杨丽丽,孙利平. HMGB1及TLR2、TLR4在类风湿关节炎中的表达及意义[J].基础医学与临床,2013,33(4):66-68.
[7]张晨光,任峰,王辉,等. HMGB1与其受体分子信号转导通路的研究进展[J].中国免疫学杂志,2014,30(2):2-5.
[8]Zhang X,Zhu C,Wu D,et al. Possible role of toll-like receptor 4in acute pancreatitis[J]. Pancreas,2010,39(6):819-824.
[9]Xu GF,Guo M,Tian ZQ,et al. Increased of serum high-mobility group box chromosomal protein 1 correlated with intestinal mucosal barrier injury in patients with severe acute pancreatitis[J]. World J Emerg Surg,2014,9:61.
[10]夏敏,张婷,郭继中,等.高迁移率族蛋白1在急性坏死性胰腺炎伴器官功能损害中的作用及其抗体的保护作用[J].中华胰腺病杂志,2013,18(1):75-76.
[2]Banks PA,Bollen TL,Dervenis C,et al. Classification of acute pancreatitis-2012:revision of the Atlanta classification and definitions by international consensus[J]. Gut,2013,62(1):102-111.
[3]Harris HE,Andersson U,Pisetsky DS. HMGB1:a multifunctional alarmin driving autoimmune and inflammatory disease[J]. Nat Rev Rheu-matol,2012,8(4):195-202.
[4]Lin Y,Lin LJ,Jin Y,et al. Correlation between serum levels of high mobility group box-1 protein and pancreatitis:a meta-analysis[J]. Biomed Res Int,2015,2015:430185.
[5]何志捷,植耀炜,黄超泰,等.血清二胺氧化酶、D-乳酸和细菌内毒素在重症患者肠道功能评估中的作用[J].岭南现代临床外科,2017,17(4):664-666.
[6]米亚英,杨丽丽,孙利平. HMGB1及TLR2、TLR4在类风湿关节炎中的表达及意义[J].基础医学与临床,2013,33(4):66-68.
[7]张晨光,任峰,王辉,等. HMGB1与其受体分子信号转导通路的研究进展[J].中国免疫学杂志,2014,30(2):2-5.
[8]Zhang X,Zhu C,Wu D,et al. Possible role of toll-like receptor 4in acute pancreatitis[J]. Pancreas,2010,39(6):819-824.
[9]Xu GF,Guo M,Tian ZQ,et al. Increased of serum high-mobility group box chromosomal protein 1 correlated with intestinal mucosal barrier injury in patients with severe acute pancreatitis[J]. World J Emerg Surg,2014,9:61.
[10]夏敏,张婷,郭继中,等.高迁移率族蛋白1在急性坏死性胰腺炎伴器官功能损害中的作用及其抗体的保护作用[J].中华胰腺病杂志,2013,18(1):75-76.