急性胰腺炎患者血清IL-33及sST2水平变化及临床意义

Variations of serum IL-33 and sST2 levels in patients with acute pancreatitis and its clinical significance

关键词:  白细胞介素-33  sST2  急性胰腺炎

Key words:  interleukin-33  soluble ST2  acute pancreatitis

摘要:

目的　探讨IL-33与其分泌性受体sST2在重型和轻型急性胰腺炎(acute pancreatitis，AP)患者血清中的水平变化及临床意义。　方法　选取AP患者36例（AP组），其中轻型（mild acute pancreatitis, MAP）16例，重型（severe acute pancreatitis, SAP）20例。分别于入院后第1、3、7和14天抽取空腹外周静脉血，正常对照组18例于清晨一次性抽取，采用酶联免疫吸附测定法(ELISA法)测定血清IL-33和sST2的浓度，并分析IL-33/sST2水平与轻重胰腺炎及与Ranson′s评分的相关性。　结果　(1)入院后第1天血清IL-33水平SAP组与正常对照组比较，明显升高(P<0.05）；而血清sST2水平SAP组和MAP组与正常对照组比较，均显著降低（P<0.01）。（2）SAP患者第1、3、7、14天血清IL-33显著高于MAP组（P<0.01）。（3）AP组血清IL-33和sST2水平在入院第3天呈正相关（r=0.337, P<0.05）。其中SAP组血清IL-33和sST2水平在第1、3天呈正相关（r=0.490, P<0.05和r=0.574, P<0.01）。（4）AP患者入院后第1天的血清IL-33水平与Ranson′s评分呈正相关（r=0.436，P<0.01）。　结论　IL-33可能在SAP早期参与促炎作用，并反映SAP的严重程度及转归。sST2是AP早期反应和急性炎症的参与者，在AP过程中起到一种保护作用。它们在AP中存在一定的相互制约。

Abstract:

Objective To study changes and clinical significance of serum interleukin-33 (IL-33) and its soluble receptor sST2 levels in patients with mild or severe acute pancreatitis（AP）. Methods Totally, 36 AP patients were selected and divided into mild acute pancreatitis group（MAP, n=16）and severe acute pancreatitis group（SAP, n=20）. Fasting venous blood samples were drawn on the day of admission and were repeated at 3，7 and 14 days later. Venous blood samples from 18 healthy volunteers were drawn one time as controls. Serum IL-33 and sST2 levels were measured by enzyme linked immunosorbent assays and were correlated with the severity of acute pancreatitis. Results (1) Serum IL-33 level in the SAP group was significantly higher than that in the control group on the 1st day（P<0.05）. Serum sST2 levels in the MAP and SAP groups were both significantly lower than that of the control group on the 1st day（P<0.01）. (2) Compared to those in the MAP group, serum IL-33 levels in the SAP group were significantly increased on the 1st, 3rd, 7th and 14th day after admission（P<0.01）. (3) Serum IL-33 level in the AP patients showed a positive correlation with Serum sST2 level on the 3rd day（r=0.337, P<0.05）and on the 1st and the 3rd day in the SAP group（SAP 1d：r=0.490, P<0.05；SAP 3d：r=0.574, P<0.01）. (4) Serum IL-33 level in the AP patients showed a good positive correlation with Ranson′s 11 criteria on the 1st day（r=0.436，P<0.01）. Conclusion IL-33 may have proinflammatory effects in the early phase of SAP and its serum level reflects the severity and prognosis of SAP. sST2 is a participant of early-phase reaction and in AP and plays a protection role. These two cytokines interact and regulate each other during AP.