摘要
背景:急性胰腺炎(AP)是临床常见的急腹症,肠黏膜屏障损伤引起继发感染是AP患者死亡的主要原因之一。近年动物模型研究发现高迁移率族蛋白B1(HMGB1)在AP肠黏膜屏障损伤中发挥重要作用。目的:研究HMGB1与AP患者肠黏膜屏障损伤的关系。方法:纳入2007年12月～2009年3月南京大学医学院附属鼓楼医院和中国人民解放军第101医院收治、确诊的AP患者80例,其中重症急性胰腺炎(SAP)38例,轻症急性胰腺炎(MAP)42例,选取30名同期健康体检者作为正常对照组。检测患者血清HMGB1含量,分析其与AP病情严重程度、血清内毒素含量、二胺氧化酶(DAO)含量、尿液乳果糖/甘露醇(L/M)比值的关系。结果:SAP组和MAP组血清HMGB1含量、内毒素含量、DAO含量和尿液L/M比值与对照组相比显著升高(P<0.05)。患者血清HMGB1含量与血清内毒素含量、DAO含量、尿液L/M比值以及Ranson评分、24 h APACHEⅡ评分、Balthazar CT评分均呈正相关(P<0.001)。结论:血清HMGB1含量可反映AP病情严重程度,并可作为判断AP患者肠黏膜屏障损伤的参考指标。
Background： Acute pancreatitis （AP） is a common acute abdomen of digestive system, secondary infection induced by intestinal mueosal barrier injury is one of the main causes of death in AP. Recent experimental studies have shown that high mobility group box 1 （HMGB1） plays an important role in the intestinal mueosal barrier injury of AP. Aims： To define the relationship between HMGB1 and intestinal mucosal barrier injury of AP patients. Methods： A total of 80 AP patients from Dec. 2007 to Mar. 2009 at Drum Tower Hospital of Nanjing University Medical School and 101th Hospital of People＇s Liberation Army were enrolled, 38 cases were severe acute pancreatitis （SAP） and 42 were mild acute pancreatitis （MAP）. Thirty healthy subjects were served as controls. Serum levels of HMGB1, endotoxin, diamine oxidase （DAO） and urine lactose/mannitol （L/M） ratio were determined and the relationships between HMGB1 and AP severity, endotoxin, DAO, L/M ratio were analyzed. Results： Compared with heahhy control group, serum levels of HMGB1, endotoxin, DAO and I_/M ratio increased significantly in SAP and MAP groups （P 〈 0.05 ）. Serum level of HMGB1 was positively correlated with the serum levels of endotoxin, DAO, urine L/M ratio, as well as the Ranson score, 24 h APACHE Ⅱ score and Bahhazar CT score （P 〈 0. 001 ）. Conclusions ： Serum HMGB1 level reflects the severity of AP and might be used as a reference parameter for the intestinal mucosal barrier injury of patients with AP.
出处
《胃肠病学》
2012年第11期669-672,共4页
Chinese Journal of Gastroenterology
基金
南京大学中央高校科研资助项目(021414340038)资助
