奥曲肽联合红花黄色素对重症急性胰腺炎血生化指标的影响
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摘要
目的:研究奥曲肽联合红花黄色素治疗对重症急性胰腺炎患者炎症细胞因子、内分泌激素、信号分子等生化指标影响。方法:选择在我院诊断为重症急性胰腺炎的患者,随机分为接受奥曲肽联合红花黄色素+常规对症治疗的实验组、奥曲肽+常规对症治疗的对照组。治疗前及治疗后5、10d时,测定血清中炎症细胞因子及内分泌激素的含量、外周血中信号分子的表达量。结果:治疗后5、10d时,两组血清中TNF-α、ICAM-1、MCP-1、IL-8、sTREM-1、COR、PCT、copeptin、AT-Ⅱ、ghrelin的含量以及外周血中FasL、NOX2、TLR4、TLR9、p38MAPK的表达强度均低于治疗前,且实验组治疗后5、10d时血清中TNF-α、ICAM-1、MCP-1、IL-8、sTREM-1、COR、PCT、copeptin、AT-Ⅱ、ghrelin的含量以及外周血中FasL、NOX2、TLR4、TLR9、p38MAPK的表达强度均显著低于对照组。结论:奥曲肽联合红花黄色素治疗重症急性胰腺炎能够更为显著改善炎症反应激活及内分泌激素紊乱。
Objective:To study the effect of octreotide combined with carthamin yellow on inflammatory cytokines,endocrine hormones and signaling molecules in patients with severe acute pancreatitis.Methods:The patients who were diagnosed with severe acute pancreatitis in Our hospital between June 2014 and October 2017 were selected and randomly divided into the experimental group who accepted octreotide combined with carthamin yellow + conventional symptomatic treatment and the control group who accepted octreotide + conventional symptomatic treatment.Before treatment as well as 5 dand 10 dafter treatment,the contents of inflammatory cytokines and endocrine hormones in serum as well as the expression of signaling molecules in peripheral blood were measured.Results:At 5 dand 10 dafter treatment,serum TNF-α,ICAM-1,MCP-1,IL-8,sTREM-1,COR,PCT,copeptin,AT-Ⅱ and ghrelin contents as well as peripheral blood FasL,NOX2,TLR4,TLR9 and p38 MAPK expression intensity of both groups were significantly lower than those before treatment,and serum TNF-α,ICAM-1,MCP-1,IL-8,sTREM-1,COR,PCT,copeptin,AT-Ⅱ and ghrelin contents as well as peripheral blood FasL,NOX2,TLR4,TLR9 and p38 MAPK expression intensity of experimental group at 5 dand 10 dafter treatment were significantly lower than those of control group.Conclusion:Octreotide combined with carthamin yellow therapy for severe acute pancreatitis can significantly improve the inflammatory response activation and endocrine hormone disorder.
Objective:To study the effect of octreotide combined with carthamin yellow on inflammatory cytokines,endocrine hormones and signaling molecules in patients with severe acute pancreatitis.Methods:The patients who were diagnosed with severe acute pancreatitis in Our hospital between June 2014 and October 2017 were selected and randomly divided into the experimental group who accepted octreotide combined with carthamin yellow + conventional symptomatic treatment and the control group who accepted octreotide + conventional symptomatic treatment.Before treatment as well as 5 dand 10 dafter treatment,the contents of inflammatory cytokines and endocrine hormones in serum as well as the expression of signaling molecules in peripheral blood were measured.Results:At 5 dand 10 dafter treatment,serum TNF-α,ICAM-1,MCP-1,IL-8,sTREM-1,COR,PCT,copeptin,AT-Ⅱ and ghrelin contents as well as peripheral blood FasL,NOX2,TLR4,TLR9 and p38 MAPK expression intensity of both groups were significantly lower than those before treatment,and serum TNF-α,ICAM-1,MCP-1,IL-8,sTREM-1,COR,PCT,copeptin,AT-Ⅱ and ghrelin contents as well as peripheral blood FasL,NOX2,TLR4,TLR9 and p38 MAPK expression intensity of experimental group at 5 dand 10 dafter treatment were significantly lower than those of control group.Conclusion:Octreotide combined with carthamin yellow therapy for severe acute pancreatitis can significantly improve the inflammatory response activation and endocrine hormone disorder.
引文
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4 He Z,Hua J,Qian D,et al.Intravenous hMSCs ameliorate acute pancreatitis in mice via secretion of tumor necrosis Factor-αstimulated Gene/Protein 6[J].Sci Rep,2016,5(6):38438.
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6 Yang YZ,Xiang Y,Chen M,et al.Clinical significance of dynamic detection for serum levels of MCP-1,TNF-αand IL-8in patients with acute pancreatitis[J].Asian Pac J Trop Med,2016,9(11):1111-1114.
7 Ku Y,Hong SM,Fujikura K,et al.IL-8expression in granulocytic epithelial lesions of idiopathic duct-centric pancreatitis(type 2autoimmune pancreatitis)[J].Am JSurg Pathol,2017,41(8):1129-1138.
8 Liu M,Wu W,Zhao Q,et al.High expression levels of trigger receptor expressed on myeloid cells-1on neutrophils associated with increased severity of acute pancreatitis in mice[J].Biol Pharm Bull,2015,38(10):1450-1457.
9 Nebiker CA,Staubli S,Schfer J,et al.Cortisol outperforms novel cardiovascular,inflammatory,and neurohumoral biomarkers in the prediction of outcome in acute pancreatitis[J].Pancreas,2018,47(1):55-64.
10 Dias BH,Rozario AP,Olakkengil SA,et al.procalcitonin strip test as an independent predictor in acute pancreatitis[J].Indian J Surg,2015,77(Suppl 3):1012-1017.
11 Soyalp M,Yalcin M,Oter V,et al.Investigation of procalcitonin,IL-6,oxidative stress index(OSI)plasma and tissue levels in experimental mild and severe pancreatitis in rats[J].Bratisl Lek Listy,2017,118(3):137-141.
12 Sang G,Du JM,Chen YY,et al.Plasma copeptin levels are associated with prognosis of severe acute pancreatitis[J].Peptides,2014,51:4-8.
13 Pan Z,Feng L,Long H,et al.Effects of local pancreatic renin-angiotensin system on the microcirculation of rat with severe acute pancreatitis[J].Korean J Physiol Pharmacol,2015,19(4):299-307.
14 Wang H,Qin M,Liang Z,et al.Serum ghrelin,but not obestatin,is a potential predictor of acute pancreatitis severity[J].Medicine(Baltimore),2017,96(35):e7963.
15 Pinhu L,Qin Y,Xiong B,et al.Overexpression of Fas and FasL is associated with infectious complications and severity of experimental severe acute pancreatitis by promoting apoptosis of lymphocytes[J].Inflammation,2014,37(4):1202-1212.
16 Deng W,Abliz A,Xu S,et al.Severity of pancreatitis?偉cassociated intestinal mucosal barrier injury is reduced following treatment with the NADPH oxidase inhibitor apocynin[J].Mol Med Rep,2016,14(4):3525-3534.
17 Jakkampudi A,Jangala R,Reddy BR,et al.NF-κB in acute pancreatitis:Mechanisms and therapeutic potential[J].Pancreatology,2016,16(4):477-488.
18 Li G,Wu X,Yang L,et al.TLR4-mediated NF-κB signaling pathway mediates HMGB1-induced pancreatic injury in mice with severe acute pancreatitis[J].Int J Mol Med,2016,37(1):99-107.
19 Cao MH,Xu J,Cai HD,et al.p38MAPK inhibition alleviates experimental acute pancreatitis in mice[J].Hepatobiliary Pancreat Dis Int,2015,14(1):101-106.
2 Portelli M,Jones CD.Severe acute pancreatitis:pathogenesis,diagnosis and surgical management[J].Hepatobiliary Pancreat Dis Int,2017,16(2):155-159.
3高斌,汪波,王菲,等.红花黄色素联合生长抑素治疗急性胰腺炎患者效果分析[J].中外医学研究,2017,15(34):27-28.
4 He Z,Hua J,Qian D,et al.Intravenous hMSCs ameliorate acute pancreatitis in mice via secretion of tumor necrosis Factor-αstimulated Gene/Protein 6[J].Sci Rep,2016,5(6):38438.
5 Han X,Wang Y,Chen H,et al.Enhancement of ICAM-1via the JAK2/STAT3signaling pathway in a rat model of severe acute pancreatitis-associated lung injury[J].Exp Ther Med,2016,11(3):788-796.
6 Yang YZ,Xiang Y,Chen M,et al.Clinical significance of dynamic detection for serum levels of MCP-1,TNF-αand IL-8in patients with acute pancreatitis[J].Asian Pac J Trop Med,2016,9(11):1111-1114.
7 Ku Y,Hong SM,Fujikura K,et al.IL-8expression in granulocytic epithelial lesions of idiopathic duct-centric pancreatitis(type 2autoimmune pancreatitis)[J].Am JSurg Pathol,2017,41(8):1129-1138.
8 Liu M,Wu W,Zhao Q,et al.High expression levels of trigger receptor expressed on myeloid cells-1on neutrophils associated with increased severity of acute pancreatitis in mice[J].Biol Pharm Bull,2015,38(10):1450-1457.
9 Nebiker CA,Staubli S,Schfer J,et al.Cortisol outperforms novel cardiovascular,inflammatory,and neurohumoral biomarkers in the prediction of outcome in acute pancreatitis[J].Pancreas,2018,47(1):55-64.
10 Dias BH,Rozario AP,Olakkengil SA,et al.procalcitonin strip test as an independent predictor in acute pancreatitis[J].Indian J Surg,2015,77(Suppl 3):1012-1017.
11 Soyalp M,Yalcin M,Oter V,et al.Investigation of procalcitonin,IL-6,oxidative stress index(OSI)plasma and tissue levels in experimental mild and severe pancreatitis in rats[J].Bratisl Lek Listy,2017,118(3):137-141.
12 Sang G,Du JM,Chen YY,et al.Plasma copeptin levels are associated with prognosis of severe acute pancreatitis[J].Peptides,2014,51:4-8.
13 Pan Z,Feng L,Long H,et al.Effects of local pancreatic renin-angiotensin system on the microcirculation of rat with severe acute pancreatitis[J].Korean J Physiol Pharmacol,2015,19(4):299-307.
14 Wang H,Qin M,Liang Z,et al.Serum ghrelin,but not obestatin,is a potential predictor of acute pancreatitis severity[J].Medicine(Baltimore),2017,96(35):e7963.
15 Pinhu L,Qin Y,Xiong B,et al.Overexpression of Fas and FasL is associated with infectious complications and severity of experimental severe acute pancreatitis by promoting apoptosis of lymphocytes[J].Inflammation,2014,37(4):1202-1212.
16 Deng W,Abliz A,Xu S,et al.Severity of pancreatitis?偉cassociated intestinal mucosal barrier injury is reduced following treatment with the NADPH oxidase inhibitor apocynin[J].Mol Med Rep,2016,14(4):3525-3534.
17 Jakkampudi A,Jangala R,Reddy BR,et al.NF-κB in acute pancreatitis:Mechanisms and therapeutic potential[J].Pancreatology,2016,16(4):477-488.
18 Li G,Wu X,Yang L,et al.TLR4-mediated NF-κB signaling pathway mediates HMGB1-induced pancreatic injury in mice with severe acute pancreatitis[J].Int J Mol Med,2016,37(1):99-107.
19 Cao MH,Xu J,Cai HD,et al.p38MAPK inhibition alleviates experimental acute pancreatitis in mice[J].Hepatobiliary Pancreat Dis Int,2015,14(1):101-106.