凉膈散干预治疗对急性胰腺炎患者血清相关miRNAs水平的影响
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摘要
目的观察中医药经典汤剂凉膈散干预治疗对急性胰腺炎患者血清相关mi RNAs水平的影响并探讨其机制。方法连续性收录2014年1月至2016年12月本院重症医学科收治的中重症/重症急性胰腺炎(MSAP/SAP)患者共46例,随机数字表法分为凉膈散组和对照组。两组患者分别于入组前和治疗后第10日检测mi R-216和mi R-92水平,并进行APACHEⅡ评分和Ranson评分,评估病情危重程度。结果在治疗后第10日,两组患者血清mi R-216和mi R-92均明显下降(P<0.05),凉膈散组患者mi R-216和mi R-92均明显低于对照组(P<0.05)。治疗后凉膈散组患者APACHEⅡ评分明显下降(P<0.05)。凉膈散组患者APACHEⅡ评分和Ranson评分均明显低于对照组(P<0.05)。凉膈散干预治疗与mi R-216和mi R-92呈正相关。结论凉膈散干预治疗可以明显降低MSAP/SAP血清AP相关mi R-216和mi R-92浓度,改善患者临床预后。
Objective:To evaluate the effect of Liangge Decoction on serum pancreatitis related mi RNA in patients with moderate/severe acute pancreatitis(MSAP/SAP).Methods:46 patients with MSAP/SAP were enrolled in this study and divided into two groups equally and randomly:LGS group and the control group.The levels of mi R-216 and mi R-92 were measured on admission day(T0) and ten days after treatment(T1).APACHE II and Ranson score were used for disease assessment.Results:The contents of mi R-216 and mi R-92 in both LGS group and the control group were significantly reduced on T1.The levels of mi R-216 in LGS group were lower than those in control group on T1(P < 0.05).The levels of △mi R-216(P < 0.05) and △mi R-92(P < 0.05) in LGS group were higher than those in control group.The levels of APACHEⅡ in LGS group were significantly decreased on T1(P < 0.05).Both △APACHEⅡ(P < 0.05) and △Ranson(P < 0.05) in LGS group were higher than those in the control group.Correlation analysis showed that Liangge Decoction treatment was positively associated with △mi R-216(r = 0.688,P < 0.05) and △mi R-92(r = 0.613,P < 0.05).Cox regression analysis suggested that Liangge Decoction might reduced the 28 day mortality in MSAP/SAP patients.Conclusion:Liangge Decoction may improve the prognosis of MSAP/SAP patients by reducing serum levels of mi R-216 and mi R-92 related to serum AP.
Objective:To evaluate the effect of Liangge Decoction on serum pancreatitis related mi RNA in patients with moderate/severe acute pancreatitis(MSAP/SAP).Methods:46 patients with MSAP/SAP were enrolled in this study and divided into two groups equally and randomly:LGS group and the control group.The levels of mi R-216 and mi R-92 were measured on admission day(T0) and ten days after treatment(T1).APACHE II and Ranson score were used for disease assessment.Results:The contents of mi R-216 and mi R-92 in both LGS group and the control group were significantly reduced on T1.The levels of mi R-216 in LGS group were lower than those in control group on T1(P < 0.05).The levels of △mi R-216(P < 0.05) and △mi R-92(P < 0.05) in LGS group were higher than those in control group.The levels of APACHEⅡ in LGS group were significantly decreased on T1(P < 0.05).Both △APACHEⅡ(P < 0.05) and △Ranson(P < 0.05) in LGS group were higher than those in the control group.Correlation analysis showed that Liangge Decoction treatment was positively associated with △mi R-216(r = 0.688,P < 0.05) and △mi R-92(r = 0.613,P < 0.05).Cox regression analysis suggested that Liangge Decoction might reduced the 28 day mortality in MSAP/SAP patients.Conclusion:Liangge Decoction may improve the prognosis of MSAP/SAP patients by reducing serum levels of mi R-216 and mi R-92 related to serum AP.
引文
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[11]Zhang XX,Deng LH,Chen WW,et al.Circulating micro RNA216 as a marker for the early identification of severe acute pancreatitis[J].American Journal of the Medical Sciences,2017,29(2):178-186.
[12]Jun Yu,Ang Li,Seung-Mo Hong,Ralph H.Hruban,Michael Goggins.Micro RNA alterations of pancreatic intraepithelial neoplasms(Pan INs)[J].Clinical Cancer Research,2011,18(4):981.
[13]Chen Y,Tian L,Wan S,et al.Micro RNA-17-92 cluster regulates pancreatic beta-cell proliferation and adaptation[J].Molecular&Cellular Endocrinology,2016,437(C):213-223.
[14]Yang J,Zeng Y.Identification of mi RNA-m RNA crosstalk in pancreatic cancer by integrating transcriptome analysis[J].European Review for Medical&Pharmacological Sciences,2015,19(5):825.
[15]范晓彬,李文星,陈炳合,等.连翘对重症急性胰腺炎大鼠肝组织中NF-κB和Foxp3表达的影响[J].临床肝胆病杂志,2013,29(7):503-507.
[16]金琦,蔡天蕊,黄朔,等.黄芩对急性重症胰腺炎大鼠肝损伤的预防及治疗作用研究[J].中国现代医学杂志,2016,26(1):18-23.
[17]司立洲,卓越.栀子苷对大鼠急性胰腺炎胰腺组织GSH、SOD含量改变的研究[J].齐齐哈尔医学院学报,2015,29(8):1101-1102.
[18]芶宇.重用生大黄和芒硝治疗急性胰腺炎的疗效观察[J].中国中西医结合急救杂志,2016,23(5):475-478.
[2]Kubiliun NM,Adams MA,Akshintala VS,et al.Evaluation of pharmacologic prevention of pancreatitis following endoscopic retrograde cholangiopancreatography:a systematic review[J].Clinical Gastroenterology&Hepatology,2015,13(7):1231.
[3]孙备,苏维宏.急性胰腺炎诊治的现状与进展[J].临床外科杂志,2015,23(2):168-170.
[4]张静姝,王勇强,王兵,等.加味凉膈散对脂多糖刺激小鼠血小板活化标志物及炎症因子释放的影响[J].中国中西医结合急救杂志,2015,23(2):133-137.
[5]裴颖皓.mi RNA在急性心肌梗死诊断中的研究进展[J].医学综述,2014,20(4):616-618.
[6]Liu P,Xia L,Zhang WL,et al.Identification of serum micro RNAs as diagnostic and prognostic biomarkers for acute pancreatitis[J].Pancreatology,2014,14(3):159-166.
[7]钱安瑜,张茂.美国胃肠病学会急性胰腺炎临床处理指南(2013版)[J].中华急诊医学杂志,2013,22(12):1324-1325.
[8]吴金雁,金士毛,王小云,等.急性胰腺炎相关micro RNA研究进展[J].国际消化病杂志,2014,21(6):386-388.
[9]Endo K,Weng H,Kito N,et al.Mi R-216a and mi R-216b as markers for acute phased pancreatic injury[J].Biomedical Research,2013,34(4):179-188.
[10]傅冬阳,黄元林,陈建洪.mi RNA在急性胰腺炎诊断和评估病情严重程度的作用[J].临床和实验医学杂志,2016,15(14):1398-1401.
[11]Zhang XX,Deng LH,Chen WW,et al.Circulating micro RNA216 as a marker for the early identification of severe acute pancreatitis[J].American Journal of the Medical Sciences,2017,29(2):178-186.
[12]Jun Yu,Ang Li,Seung-Mo Hong,Ralph H.Hruban,Michael Goggins.Micro RNA alterations of pancreatic intraepithelial neoplasms(Pan INs)[J].Clinical Cancer Research,2011,18(4):981.
[13]Chen Y,Tian L,Wan S,et al.Micro RNA-17-92 cluster regulates pancreatic beta-cell proliferation and adaptation[J].Molecular&Cellular Endocrinology,2016,437(C):213-223.
[14]Yang J,Zeng Y.Identification of mi RNA-m RNA crosstalk in pancreatic cancer by integrating transcriptome analysis[J].European Review for Medical&Pharmacological Sciences,2015,19(5):825.
[15]范晓彬,李文星,陈炳合,等.连翘对重症急性胰腺炎大鼠肝组织中NF-κB和Foxp3表达的影响[J].临床肝胆病杂志,2013,29(7):503-507.
[16]金琦,蔡天蕊,黄朔,等.黄芩对急性重症胰腺炎大鼠肝损伤的预防及治疗作用研究[J].中国现代医学杂志,2016,26(1):18-23.
[17]司立洲,卓越.栀子苷对大鼠急性胰腺炎胰腺组织GSH、SOD含量改变的研究[J].齐齐哈尔医学院学报,2015,29(8):1101-1102.
[18]芶宇.重用生大黄和芒硝治疗急性胰腺炎的疗效观察[J].中国中西医结合急救杂志,2016,23(5):475-478.