本文選題：白介素33　切入點：瘤變抑制因子2　出處：《山西醫(yī)科大學》2017年碩士論文

【摘要】：目的:檢測急性胰腺炎患者及其合并腎損傷時血漿中IL-33/s ST2的表達情況,探討IL-33/s ST2與急性胰腺炎病情嚴重程度的關系,并且分析IL-33和s ST2在急性胰腺炎合并急性腎損傷機制中所發(fā)揮的促炎作用,進而可以為我們在臨床上對于急性胰腺炎合并腎損傷的早期診斷和早期治療從分子學角度提供幫助。方法:臨床收集山西醫(yī)科大學第二醫(yī)院普外科、山西省人民醫(yī)院消化科2016年01月至2016年12月收治并診斷為急性胰腺炎(acute pancreatitis,AP)的60例患者當作實驗組,而且依據AP患者有否合并有急性腎損傷(acute kidney injury,AKI),將實驗組分為AKI組和非AKI組,其中非AKI組52例,AKI組8例;選擇同期的健康者30例來作為對照組。采集所有入選實驗組非AKI組患者入院第1天,AKI組入院第1、3、7、14天的晨起空腹血標本和對照組的隨機晨起空腹血標本,然后運用酶聯(lián)免疫吸附測定法(ELISA法)來檢測所有血標本中IL-33和s ST2的值以及其他相關的血清生化指標,討論各指標間的相互關系并分析他們的臨床意義。結果:1.在非AKI組中,患者血清中IL-33的平均水平為:(137.5±18.5)pg/ml;在AKI組中,患者血清中IL-33的平均水平為:(278.3±23.4)pg/ml;在正常健康對照組中,血清中IL-33的平均水平為:(42.7±20.1)pg/ml。急性胰腺炎(AP)患者的血清中IL-33的表達水平較正常健康對照者升高,并且各個組之間均有差異,且其差異有統(tǒng)計學意義((49)0.01)。2.在非AKI組中,患者血清中s ST2的平均水平為:(123.8±20.3)pg/ml;在AKI組中,患者血清中s ST2的平均水平為:(212.7±19.5)pg/ml;在正常健康對照組中,血清中s ST2的平均水平為:(64.9±21.7)pg/ml。急性胰腺炎(AP)患者血清中s ST2的表達水平較正常健康對照組升高,并且各個組之間均有差異,且其差異有統(tǒng)計學意義((49)0.05)。3.血清中IL-33和s ST2的表達水平呈正相關(r=0.805,(49)0.01)。4.在急性胰腺炎合并AKI患者血清中IL-33、s ST2、Cr的水平在入院第3天水平升高,且與入院第1天的水平有差異,其差異有統(tǒng)計學意義((49)0.05);入院第7天IL-33、s ST2、Cr的水平較第3天降低,與第1天的差異無統(tǒng)計學意義;入院第14天IL-33、s ST2、Cr的水平較第7天降低,與第1天、第3天的水平有差異,其差異有統(tǒng)計學意義((49)0.05)。5.在急性在急性胰腺炎合并AKI患者血清中IL-33、s ST2、Cr的水平在入院第3天水平升高,第7天、第14天水平下降,且IL-33的下降較s ST2、Cr明顯。結論:對于急性胰腺炎合并急性腎損傷患者,其血清中IL-33及s ST2的表達水平可以更好的評估腎功能。IL-33在急性胰腺炎合并腎損傷的炎癥機制中發(fā)揮有一定的促進作用,s ST2在急性胰腺炎合并腎損傷的炎癥機制中起保護作用。
[Abstract]:Objective: to investigate the expression of IL-33/s ST2 in plasma of patients with acute pancreatitis and its associated renal injury, and to explore the relationship between IL-33/s ST2 and severity of acute pancreatitis. The role of IL-33 and s ST2 in acute pancreatitis with acute renal injury was analyzed. It may be helpful to us in the early diagnosis and early treatment of acute pancreatitis with renal injury from a molecular perspective. Methods: general surgery of the second Hospital of Shanxi Medical University. From January 2016 to December 2016, the Department of Digestive Medicine of Shanxi Provincial people's Hospital treated 60 patients with acute pancreatitis as experimental group, and divided the experimental group into AKI group and non-#en2# group according to whether the AP patients had acute kidney injuryAkei. Among them, 52 cases were non-#en0# group and 8 cases were non-AKI group. 30 healthy subjects were selected as control group. Fasting blood samples were collected from the first day of admission to the AKI group on the first day of admission and from day 1 to day 14 in the control group. Then Elisa was used to detect the values of IL-33 and s ST2 in all blood samples, as well as other related serum biochemical indexes, to discuss the relationship between the indexes and to analyze their clinical significance. Results: 1. In the non AKI group, The average level of IL-33 in patients' serum was 137.5 鹵18.5g / ml, in the AKI group, the average level of IL-33 was 278.3 鹵23.4g / ml. In the normal control group, the average level of IL-33 was 278.3 鹵23.4g / ml. The average level of IL-33 in serum was 42.7 鹵20.1g / ml. The expression of IL-33 in serum of patients with acute pancreatitis was higher than that of normal controls, and there were significant differences among different groups, and the difference was statistically significant. The average level of s ST2 in patients' serum was 123.8 鹵20.3 g / ml; in AKI group, the average level of s ST2 was 212.7 鹵19.5pg / ml; in the normal control group, the average level of s ST2 was 212.7 鹵19.5pg / ml; in the normal control group, the average level of s ST2 was 212.7 鹵19.5g / ml. The average level of s ST2 in serum was 64.9 鹵21.7 PG / ml. The expression of s ST2 in the serum of patients with acute pancreatitis was higher than that of the normal control group, and there were differences between the two groups. There was a positive correlation between the expression of IL-33 and s ST2 in the serum of patients with acute pancreatitis complicated with AKI, and the level of IL-33 / S ST2Cr increased on the third day of admission, and there was a difference between the levels on the third day of admission and the level of s ST2 on the first day of admission, and there was a positive correlation between the expression of IL-33 and s ST2 in the serum of patients with acute pancreatitis complicated with AKI. The difference was statistically significant (P < 0. 05), the level of IL-33N ST2Cr on the 7th day of admission was lower than that on the third day, but there was no significant difference between the first day and the first day, and on the 14th day of admission, the level of IL-33 + s ST2ncr was lower than that on the 7th day, which was different from that of the first day and the third day. There was a significant difference in serum levels of IL-33 and ST2nCr in patients with acute pancreatitis complicated with AKI on the 3rd day of admission, and decreased on the 7th and 14th day after admission, and there was a significant difference between the two groups in the serum levels of IL-33 and ST2ncr in the patients with acute pancreatitis complicated with AKI, the difference was statistically significant (P < 0.05). The decrease of IL-33 was significantly higher than that of sST2Cr. Conclusion: in patients with acute pancreatitis complicated with acute renal injury, The expression of IL-33 and s ST2 in serum can better evaluate the role of IL-33 in the inflammatory mechanism of acute pancreatitis complicated with renal injury. The expression of s ST2 may play a protective role in the inflammatory mechanism of acute pancreatitis complicated with renal injury.
【學位授予單位】：山西醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R576;R692

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