| Objective: Acute pancreatitis(AP) is a common clinical disease. Some studies suggest that in AP, in particular severe acute pancreatitis ( SAP), excessive activation of leucocyte can lead to a large number of release of inflammatory mediators and cytokines, then resulting in cascade reaction, thereby triggering the systemic inflammatory response syndrome (SIRS) and multiple organ failure syndrome(MOFS). That lead to high death rate and bad therapeutic efficacy of SAP up to now, to block the release of cell factor and inflammatory mediators can improve the therapeutic efficacy.Monocyte chemoattractant protein-1(MCP-1) is a new chemotactic factor of CC, it has chemotaxis of monocyte in vivo and vitro monocyte, it can advance adhesion molecule expression and cytokine production. Animal experiments confirmed that MCP-1 participated the development of AP. When pancreatic glandular cell is stimulated, MCP-1 rapidly produce and mononuclear macrophage activate, result in a great quantity of cytokine released, oxygen radicals production and the vasomotion changed, all mechanisms can injure the pancreas and other systems all over the body. The level of MCP-1 in the serum with AP patients are determined in this experiment, we analyzed the correlation with severity and complications of AP, and investigated the role of MCP-1 in AP and the clinical significance.Methods: Twenty patients with acute pancreatitis admitted to the second affiliated hospital He Bei Medical University during the period between May and December 2008. The series consisted of 20 patients[age range, 29-55 years and average(39.47±11.05) years] with acute pancreatitis. According to the standard of clinical diagnosis and classification of AP in Society of Surgery of China(1996), divide patients into 2 groups: MAP group and SAP group(BalthazarCT≧II, APACHE-II≧8), record exactly about diastase,urinary amylase,WBC,CRP,hyperacoustic,CT and complications after patients admission. All patients hadn't infectious diseases,tumor,autoimmune disease, hadn't special therapy(for example: radiotherapy,chemotherapy,operation within one month).Another choosing 20 healthy adults for matched control, age 23～52 years old, average (34.93±12.18) years old, age and sex ratio was comparable between patients and controls(P>0.05). The peripheral venous blood(3 milliliter) of all patients within 24h after their admission, serum was preserved in refrigerators (-20 centigrade) to measure after being separated centrifugal machine. MCP-1 values were measured by MCP-1 ELISA kit. The data were analyzed by soft ware SPSS 13.0. P value of less than 0.05 was considered statistically. Results:1 We had 20 cases in control group while 20 cases in AP group. Serum MCP-1 values were 514.83±208.90pg/ml in AP group and 374.31±129.82pg/ml in control group. Serum MCP-1 values were significantly higher in AP group than in control group,there was difference between two groups(P<0.05).2 According to the standard of clinical diagnosis and classification of AP in Society of Surgery of China (1996), divided patients into MAP group and SAP group, Serum MCP-1 values were 719.57±416.12pg/ml in SAP group , Serum MCP-1 values were 437.17±81.17pg/ml in MAP group, lower than the SAP group , there was difference between two groups(P<0.05).3 According to the standard of clinical diagnosis and classification of AP in Society of Surgery of China (1996), divided patients into two groups: the group who had complications as heart,lung,kidney failure and the other group who had not, serum MCP-1 values were 655.90±309.28pg/ml in group with complications, Serum MCP-1 values were 410.56±129.82pg/ml in the other group, lower than group with complications, there was difference between two groups(P<0.05).4 The coefficient correlation of MCP-1 values and serum amylase values is 0.7814, they had positive correlation(P<0.05). The coefficient correlation of MCP-1 values and serum CRP values is 0.8827,they has positive correlation(P<0.05).Conclusions: 1 Serum MCP-1 values were higher in acute pancreatitis than in control group within 24h,it proved that MCP-1 participate the inflammatory reaction of AP.2 Serum MCP-1 values in MAP group were lower than Serum MCP-1 values in SAP group , MCP-1 is a chemotactic factor can predict the serious degree of acute pancreatitis.3 Serum MCP-1 values in the group who had complications were higher than the group who had not, serum MCP-1 values in AP patients and serum amylase values,serum CRP values has significantly positive correlation.4 The study indicate that serum MCP-1 values participate the development of AP, may be one of mechanisms in SAP development, is a target in the diagnose of AP. |
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