| Acute pancreatitis (AP) is a common disease of digestive system, most of it is self - limited. About 15% -30% patients may become worse into severe acute pancreaitis (SAP) company with local complication or multiple organ failure. The mortality rate of SAP is very high of 30% -50%. Today the methods of treatment can only release the clinical manifestation, but can not decrease the mortality rate and the appearance of complication. Now, the pathogenesis of AP is still unknown. The role of cytokines in the pathogenesis of AP have been paid more attention. In our experiment , we detect the level of IL -15 NIL - 18 and sTNF - 1R in patients with acute pancreatitis (AP) ,as well as correlation between the three factors with AP to predict the severity of AP to analysis the correlation among them and to investigate the role of inflammatory cytokines in the pathogenesis of a-cute pancreatitis.MethodAccording to the clinical diagnosis and classificatory criterion of acute pancreatitis. 26 patients with AP were chosen , SAP group(n =7) and MAP group ( n = 19 ). All of them were taken into hospital within 24 hours after the appearance of clinical manifestation, normal compare group ( n = 10) , who has no relative diseases. All the patients were detected by ELISA to assess the level of IL - 15,IL - 18 and sTNF -1R in plasma.Result1 . The change of concentration of IL - 15. IL - 18 and sTNF -1R in plasma of the patients with APIL-15,IL-18 and sTNF - 1R in SAP group was higher than that in MAP group P <0.01 ;sTNF - 1R in SAP and MAP group was higher than that in control group P <0. 01 ;the results of IL - 15 and IL - 18 were similar; MAP group was lower than that in SAP group and control group P < 0. 01. There is no obvious difference between SAP group and control group P >0.05.2 . The correlation between IL - 15. IL - 18 and sTNF - 1R in plasma of the patients with MAPsTNF - 1 R and IL - 1 8 are obvious positive correlation , Y =-4.4279+0.0392X,r=0.98,n = 19,p<0.01;sTNF-lRandIL-15 are obvious positive correlation , Y = 1.472 +0.006X, r =0. 823,n = 19,p<0.01; IL-18 and IL - 15 are obvious positive correlation,Y = 1.795+0.145X, r=0.95,n = 19, p<0.01.3 . The correlation between IL - 15. IL - 18 and sTNF - 1R in plasma of the patients with SAPsTNF - IRandIL - 18areobviouspositivecorrelation,Y =52. 825 + 0.004X , r = 0.953 , n=7, p<0.01; sTNF-lRand IL -15 are obvious positive correlation , Y = 11.119 + 0. 004X, r = 0. 93, n = 7,p <0.01;IL-18 and IL - 15 are obvious positive correlation , Y = -45.809+1.123X, r=0.906,n=7, p<0.01.DiscussionTNFa is a very important cytokine in the inflammatory reaction . It rises in the early stage of AP. It combines with its specific receptor for its biological function, which can protect the body from damaged. In health person the concentration of sTNF - 1R is low. The result of our experiment shows that when the inflammatory reaction become worse, the function of protective system increase too. Which is correlation to the disease severity.IL - 15 is a new cytokine . Its function in the pathogenesis of AP is unknown , no relative articles have been reported. High concentration of IL - 15 can promote the production of pro - inflammatory cyto-kines, while low concentration of IL - 15 can inhibit the production of pro - inflammatory cytokines. It has no effect on and - inflammatory cytokines. The result of our experiment shows that IL - 15 can protect the body in the early stage of AP; However , the concentration of IL -15 increase with the strengthen of inflammatory reaction.IL - 18 is also a new cytokine . It is very similar to IL - 1 in functions and structures. IL - 18 increases obviously in SAP and parallel to the necrosis of the pancreas and the dysfunction of remote organs. IL -18 rises obviously within one week, so that it is very convenient for assessment . The result of our experiment shows that IL -18 is inhibited in the early stage of AP, it rises when the disease is worse.IL-15 and IL-18, IL - 18 and sTNF-1R, sTNF-1R an... |
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