ERCP术后胰腺炎患者血清CRP、PCT、IL-10水平变化及其与胰腺炎严重程度的关系

Changes in Serum CRP, PCT, and IL-10 Levels in Patients with Post-ERCP Pancreatitis and Their Relationship with the Severity of Pancreatitis

摘要: 目的：对疾病患者在行ERCP术之后发生胰腺炎(PEP)的血清C反应蛋白、白介素-10、降钙素原的变化情况与胰腺炎的严重程度相关性进行了研究。方法：选取了来我院拟实行ERCP治疗的181例胆管结石患者，分为胰腺炎组(54例)和非胰腺炎组(127例)。所有患者都在ERCP手术前后6、24小时进行血清淀粉酶、C反应蛋白、白介素-10、降钙素原的检测。结果：此次研究中发生胰腺炎患者共54例(29.8%)，其中轻型胰腺炎37例(68.52%)，重型胰腺炎17例(31.48%)，胰腺炎组病人术后血清淀粉酶均较术前显著升高(P < 0.05)。术前两组C反应蛋白，白介素-10和降钙素原,淀粉酶在统计学上无差异(P < 0.05)。术后各组C反应蛋白均明显升高，差异与术前相比具有统计学意义(P < 0.05)；胰腺炎组与非胰腺炎组术后血清淀粉酶、PEP组术后6、24 h血清淀粉酶、CRP、IL-10、PCT升高幅度均明显高于正常组(P < 0.001)。两组病人术后6、24 h轻胰腺炎重胰腺炎病人，降钙素原水平逐渐升高，血清C反应蛋白、白介素-10均明显高于术前水平(P < 0.05)。进行组间比较后发现重型胰腺炎患者术后血清C反应蛋白水平明显高于轻型胰腺炎患者(P < 0.05)。结论：C反应蛋白、白介素-10，降钙素原水平可作为监测指标来评估是否发生ERCP术后胰腺炎，而且还可对ERCP手术后胰腺炎的发病严重程度进行预测。

Abstract: Objective: The correlation between changes in serum C-reactive protein, interleukin-10, and procalcitonin levels in patients with pancreatitis (PEP) after ERCP surgery and the severity of pancreatitis was studied. Method: 181 patients with bile duct stones who planned to undergo ERCP treatment in our hospital were selected and divided into a pancreatitis group (54 cases) and a non pancreatitis group (127 cases). All patients were tested for serum amylase, C-reactive protein, interleukin-10, and procalcitonin 6 and 24 hours before and after ERCP surgery. In this study, a total of 54 patients (29.8%) experienced pancreatitis, including 37 cases of mild pancreatitis (68.52%) and 17 cases of severe pancreatitis (31.48%). The serum amylase levels in the pancreatitis group were significantly increased after surgery compared to preoperative levels (P < 0.05). There was no statistically significant difference in C-reactive protein, interleukin-10, procalcitonin, and amylase between the two groups before surgery (P < 0.05). After surgery, C-reactive protein levels in all groups were significantly increased, and the difference was statistically significant compared to preoperative levels (P < 0.05); The postoperative serum amylase levels in the pancreatitis group and non pancreatitis group, as well as the serum amylase levels, CRP, IL-10, and PCT levels in the PEP group at 6 and 24 hours postoperatively, were significantly higher than those in the normal group (P < 0.001). After 6 and 24 hours of surgery, the levels of procalcitonin gradually increased in patients with mild and severe pancreatitis in both groups, and serum C-reactive protein and interleukin-10 were significantly higher than preoperative levels (P < 0.05). After intergroup comparison, it was found that the postoperative serum C-reactive protein levels in patients with severe pancreatitis were significantly higher than those in patients with mild pancreatitis (P < 0.05). Conclusion: C-reactive protein, interleukin-10, and procalcitonin levels can be used as monitoring indicators to evaluate the occurrence of post ERCP pancreatitis, and can also predict the severity of post ERCP pancreatitis.