Chen Chun-Chia, Wang Sun-Sang, Lu Rei-Hwa, Lu Cheng-Chung, Chang Full-Young, Lee Shou-Dong
Division of Gastroenterology, Department of Medicine, Taipei Veterans General Hospital and National Yang-Ming University School of Medicine, Taipei, Taiwan.
Pancreas. 2003 May;26(4):375-80. doi: 10.1097/00006676-200305000-00011.
Endoscopic retrograde cholangiopancreatography (ERCP)-induced pancreatitis provides a model to study the time course of cytokine release during the initiation phase of pancreatitis. The early changes of inflammatory cytokines after ERCP have been unclear.
To evaluate the early changes in serum levels of proinflammatory and antiinflammatory cytokines after ERCP and to assess their value in the early recognition of post-ERCP pancreatitis.
Seventy-eight consecutive patients undergoing ERCP were prospectively studied. The serum concentrations of tumor necrosis factor alpha, interleukin-1beta, interleukin-6, interleukin-8, and interleukin-10 were determined immediately prior to and 1, 4, 8, and 24 hours after ERCP.
Seven of 78 patients (9.0%) developed post-ERCP pancreatitis. Serum levels of tumor necrosis factor alpha, interleukin-1beta, interleukin-6, interleukin-8, and interleukin-10 significantly increased at 8 and 24 hours but not at 1 and 4 hours after ERCP in patients with post-ERCP pancreatitis, in comparison with patients without pancreatitis. Using a cutoff level of 36 pg/mL for interleukin-6 at 8 hours after ERCP, we found that the sensitivity and specificity for recognition of post-ERCP pancreatitis were 100% and 87%, respectively. Serum levels of interleukin-6 and interleukin-8 modestly increased from baseline values, 1 to 24 hours after uncomplicated ERCP.
Proinflammatory and antiinflammatory cytokines significantly increased in the early stage after ERCP-induced pancreatitis. Among the inflammatory cytokines, interleukin-6 is the most useful for recognition of post-ERCP pancreatitis.
内镜逆行胰胆管造影术（ERCP）诱发的胰腺炎为研究胰腺炎起始阶段细胞因子释放的时间进程提供了一个模型。ERCP术后炎症细胞因子的早期变化尚不清楚。
评估ERCP术后促炎和抗炎细胞因子血清水平的早期变化，并评估其在ERCP术后胰腺炎早期识别中的价值。
对78例连续接受ERCP的患者进行前瞻性研究。在ERCP术前及术后1、4、8和24小时测定血清肿瘤坏死因子α、白细胞介素-1β、白细胞介素-6、白细胞介素-8和白细胞介素-10的浓度。
78例患者中有7例（9.0%）发生了ERCP术后胰腺炎。与未发生胰腺炎的患者相比，ERCP术后胰腺炎患者血清肿瘤坏死因子α、白细胞介素-1β、白细胞介素-6、白细胞介素-8和白细胞介素-10水平在术后8和24小时显著升高，但在术后1和4小时未升高。以ERCP术后8小时白细胞介素-6的临界值36 pg/mL为标准，我们发现识别ERCP术后胰腺炎的敏感性和特异性分别为100%和87%。在未发生并发症的ERCP术后1至24小时，白细胞介素-6和白细胞介素-8的血清水平较基线值略有升高。
ERCP诱发的胰腺炎早期促炎和抗炎细胞因子显著增加。在炎症细胞因子中，白细胞介素-6对识别ERCP术后胰腺炎最有用。
