Yonetci Nadir, Sungurtekin Ugur, Oruc Nevin, Yilmaz Mustafa, Sungurtekin Hulya, Kaleli Ilknur, Kaptanoglu Bunyamin, Yuce Gul, Ozutemiz Omer
Department of Gastroenterology, Pamukkale University School of Medicine, Denizli, Turkey.
ANZ J Surg. 2004 Jul;74(7):591-5. doi: 10.1111/j.1445-2197.2004.03059.x.
Infected necrosis in acute pancreatitis is the main factor in determining the prognosis of the disease. Early and accurate diagnosis of infected pancreatic necrosis might decrease mortality. The aim of the present study is to identify a reliable marker for the onset infection in three different experimentally induced pancreatitis models.
Ninety female Wistar albino rats were randomly divided into nine groups. In three different experimental models, including cerulein induced acute oedematous pancreatitis (AEP), sterile pancreatic necrosis due to taurocholate-induced acute pancreatitis (SPN) and infected pancreatic necrosis taurocholate-induced acute pancreatitis (IPN). Serum levels of procalcitonin (PCT), C-reactive protein (CRP), tumour necrosis factor a (TNF-alpha), interleukin 6 (IL-6) and interleukin 8 (IL-8), amylase were measured. The degree of pancreatic damage also evaluated pathologically.
Procalcitonin levels were increased significantly in AEP, SPN and IPN compared to control groups (P < 0.05). PCT and IL-6 level were the highest in the IPN group (P < 0.05). Serum amylase, CRP, TNF-alpha, IL-2, and IL-8 levels were similar between IPN and SPN groups (P > 0.05), but higher than in other groups. The results of histological evaluation also correlated with the advent of the disease.
Procalcitonin and IL-6 acts as reliable acute phase reactant in an experimental model of AEP, SPN and IPN in the rat. PCT and IL-6 combination might be surrogate marker of infected pancreatic necrosis and should be preferred to other markers assay especially in severe pancreatitis.
急性胰腺炎中的感染性坏死是决定该疾病预后的主要因素。早期准确诊断感染性胰腺坏死可能会降低死亡率。本研究的目的是在三种不同的实验性诱导胰腺炎模型中确定一种用于起始感染的可靠标志物。
90只雌性Wistar白化大鼠被随机分为9组。在三种不同的实验模型中，包括蛙皮素诱导的急性水肿性胰腺炎（AEP）、牛磺胆酸盐诱导的急性胰腺炎所致无菌性胰腺坏死（SPN）以及牛磺胆酸盐诱导的急性胰腺炎所致感染性胰腺坏死（IPN）。检测血清降钙素原（PCT）、C反应蛋白（CRP）、肿瘤坏死因子α（TNF-α）、白细胞介素6（IL-6）和白细胞介素8（IL-8）、淀粉酶水平。还对胰腺损伤程度进行了病理评估。
与对照组相比，AEP、SPN和IPN组的降钙素原水平显著升高（P<0.05）。PCT和IL-6水平在IPN组中最高（P<0.05）。IPN组和SPN组之间的血清淀粉酶、CRP、TNF-α、IL-2和IL-8水平相似（P>0.05），但高于其他组。组织学评估结果也与疾病的发生相关。
在大鼠AEP、SPN和IPN实验模型中，降钙素原和IL-6作为可靠的急性期反应物。PCT和IL-6联合检测可能是感染性胰腺坏死的替代标志物，尤其在重症胰腺炎中应优先于其他标志物检测。
