Effect of rhubarb enema on the expressions of serum HMGB-1,PCT,IL-6 and TNF-α in patients with severe acute pancreatitis

Peng Yan; Wang Xuehu; Zhou Fa Chun; Yan Ting

doi:10.13406/j.cnki.cyxb.001386

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Effect of rhubarb enema on the expressions of serum HMGB-1,PCT,IL-6 and TNF-α in patients with severe acute pancreatitis

更新时间：2024-01-17

- Effect of rhubarb enema on the expressions of serum HMGB-1,PCT,IL-6 and TNF-α in patients with severe acute pancreatitis
- Journal of Chongqing Medical University Vol. 42, Issue 9, Pages: 1166-1170(2017)
- 作者机构：
  
  1. 重庆医科大学附属第一医院重症医学科
  2. 重庆医科大学附属第一医院血管外科
  3. 重庆医科大学附属第一医院肝胆外科
- 作者简介：
- 基金信息：
- DOI：10.13406/j.cnki.cyxb.001386
  CLC： R259
- Published：2017，
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Peng Yan, Wang Xuehu, Zhou Fa Chun, et al. Effect of rhubarb enema on the expressions of serum HMGB-1,PCT,IL-6 and TNF-α in patients with severe acute pancreatitis. [J]. Journal of Chongqing Medical University 42(9):1166-1170(2017)
DOI：

Peng Yan, Wang Xuehu, Zhou Fa Chun, et al. Effect of rhubarb enema on the expressions of serum HMGB-1,PCT,IL-6 and TNF-α in patients with severe acute pancreatitis. [J]. Journal of Chongqing Medical University 42(9):1166-1170(2017) DOI： 10.13406/j.cnki.cyxb.001386.

摘要

目的:观察大黄灌肠对重症急性胰腺炎(severe acute pancreatitis

SAP)患者血清高迁移率族蛋白B1(high mobility group B1

HMGB1)、降钙素原(procalcitonin

PCT)、白细胞介素-6(interleukin-6

IL-6)、肿瘤坏死因子-α(tumor necrosis factorsα

TNF-α)及疾病预后的影响。方法:收集SAP患者60例

随机分为大黄治疗观察组组(大黄灌肠

30例)和常规治疗对照组(肥皂水灌肠

30例)

分别在入院后第1、3、5天动态监测各组患者血清的HMGB1、PCT、IL-6与TNF-α浓度变化

并观察患者腹痛腹胀缓解时间、排气排便时间、CRRT时间及2组患者的治疗效果。结果:治疗当天2组患者HMGB1、PCT、IL-6、TNF-α水平差异均无统计学意义(P值分别为0.535、0.876、0.973、0.419);不同时间点间各组炎症因子HMGB1、PCT、IL-6、TNF-α的变化存在统计学差异(P<0.01)

并且观察组HMGB1、IL-6、TNF-α的水平较对照组低(P<0.01)

而PCT表达差异不存在统计学意义(P=0.059)。Δ3-1HMGB1(第3天与第1天的HMGB1差值)与第3天急性生理与慢性健康(acute physiology and chronic health evaluation system

APACHE)Ⅱ评分呈明显负相关(P<0.01)

而PCT、IL-6、TNF-α与第3天APACHEⅡ评分均无明显相关关系(P值均大于0.05)。治疗第5天时

急性胰腺炎严重程度床边指数(bedside index for severity in AP

BISAP)观察组明显较对照组低(P=0.038)。观察组的腹痛腹胀时间、排气排便时间、CRRT时间均较对照组短(P值均小于0.01)。观察组的总体有效率也明显高于对照组(P=0.023)。结论:大黄能够有效抑制重症急性胰腺炎患者炎症因子HMGB1、PCT、IL-6、TNF-α的表达

降低BISAP评分

并且能改善SAP患者的症状和转归

而HMGB1表达量变化可能与患者预后相关。

Abstract

Objective:To observe the effect of rhubarb enema on the serum high mobility group B1（HMGB1）

procalcitonin（PCT）

interleukin-6（IL-6）and tumor necrosis factors-α（TNF-α）level in patients suffered from severe acute pancreatitis（SAP）. Methods:Sixty SAP patients were collected and randomly divided into the observation group（received rhubarb enema

30 cases）and the control group（received soapy water enema

30 cases）. The levels of HMGB1

PCT

IL-6 and TNF-α in each group were dynamically detected on 1st

3rd and 5th day after admission. Results:There was no statistical significance in the HMGB1

PCT

IL-6 and TNF-αlevel of patients in two groups before treatment（P was 0.535

0.876

0.973 and 0.419

respectively）. On the 3rd day and 5th day

the HMGB1

PCT

IL-6 and TNF-α levels of the observation group were lower than those in control group（P<0.05）. The increased value of HMGB1 between day l and day 3 was significantly negative correlated with the APACHE Ⅱscore of 3rd day in both groups

but not the same of PCT

IL-6 and TNF-α. The bedside index for severity in SAP（BISAP）score on 5th day was lower in observation group compared with that of control group（P=0.038）. The time for releasing of abdominal pain and distention

the recovery of flatus

defecation

and for CRRT was shorter in the observation group than in control group（P<0.01）. And the overall efficiency was higher in observation group than in control group（P=0.023）. Conclusion:Rhubarb can effectively inhibit the expression of the late inflammatory factor HMGB1

PCT

IL-6 and TNF-α in patients with severe acute pancreatitis

reduce the BISAP score

relieve the symptoms and improve the outcome of SAP

and the HMGB1 change level may be used as valuable parameters to evaluate the prognosis of SAP.

关键词

大黄重症急性胰腺炎高迁移率族蛋白B1降钙素原白细胞介素-6肿瘤坏死因子-α

Keywords

Rhubarbsevere acute pancreatitishigh mobility group B1procalcitonininterleukin-6tumor necrosis factors-α

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