Changes And Significance Of Substance P, IL-6 And CRP In The Serum Of Patients With Acute Pancreatitis

Acute pancreatitis is that pancreatic enzymes are actived by different etiologys,leading to pancreatic digest themselves.The clinical manifestation has abdominal pain continuously,with abdominal distention,nausea,vomiting etc discomfort.Patients with mild condition were priority to with pancreas local inflammatory response;Patients with severe condition were with organ dysfunction.The majority of patients(about 80%)were belonged to the mild acute pancreatitis(MAP).That had less sequela after active treated.Incidence of moderately severe acute pancreatitis(MSAP)and severe acute pancreatitis(SAP)was accounted for about 20%.MSAP and SAP were in dange,speedy development,and wih more complications,high mortality.Despite the development of concept,methods,and new drugs for treatment,the mortality of MSAP and SAP is markedly reduced,but the incidence of various complications are still higher,SAP is still one of the common dangerous disease clinically.Objective:the objective is to study the changes and significance of substance P,IL-6 and CRP in the serum of patients with acute pancreatitis,and to provide reference for clinical diagnosis and treatment.Methods:120 cases patients with acute pancreatitis were collected in the Second Affiliated Hospital of Hebei North University from October 2013 to September 2015 as the research object,80 men,40 women,the average age was 41.2±5.0;The control group was the 20 health physical examinations in the same period,12 men and 8 women,the average age was 40.2±4.7?According to China's "guidelines of diagnosis and treatment of acute pancreatitis(2014),acute pancreatitis were divided into mild acute pancreatitis(MAP),moderately severe acute pancreatitis and severe acute pancreatitis(MSAP and SAP).All of the patients were routinely offered comprehensive treatment after admission,including gastrointestinal decompression,acid suppression antimicrobial enzymes,maintaining water,electrolyte and acid-base imbalance,nutrition support treatment,etc.And were closely monitored the important visceras function,examinated dynamic imaging of pancreas,the problems were discovered in a timely manner to deal with;examinated dynamic abdominal CT imaging of pancreas,and the changes of illness were evaluted.All of the patients were extracted the elbow non anticoagulant 3 ml in the 1 day,3 day,7 day,10 day each after admission;The concentration of substance P,IL-6 and CRP in the serum were determined.The concentration of Substance P and IL – 6 were detected by ELISA method,the concentration of CRP was detected by immune turbidimetry.The related data were analyzed by SPSS 18.0 statistical software.Results:1 Comparison on the concentration of substance P,IL-6 and CRP of the MAP group,MSAP and SAP group,and healthy control group in the first day after admission,the concentration of substance P,IL-6 and CRP of the MAP group were 638.7±35.0 pg/ml?12.95±1.22 pg/ml?7.35±0.39 mg/L respectively;the concentration of substance P,IL-6 and CRP of the MSAP and SAP group were 1002.4±36.2 pg/ml?21.32±2.31 pg/ml?11.36±0.60 mg/L respectively,the concentration of substance P,IL-6 and CRP of the control group were 348.3±24.7 pg/ml ? 7.59±0.60 pg/ml ? 3.37±0.38 mg/L respectively,showed the concentration of MAP,MSAP and SAP group were significantly higher than the control group,there were the difference statistically significant(P<0.05).2 Comparison on the dynamic change concentration of substance P in the serm of the MAP group,MSAP and SAP group at the diffrent time.The concentration of substance P in the serm of the MAP group,MSAP and SAP group in 1 day,3 day,7 day,10 day: The concentration of substance P in the serm of the MAP group were 638.7±35.0pg/ml ? 789.0±23.8 pg/ml ?891.1±35.6pg/ml ? 804.6±31.6pg/ml respectively;The concentration of substance P in the serm of the MAP and SAP group were 1002.4±36.2pg/ml?1253.9±23.3 pg/ml ? 1402.9±31.4pg/ml ? 1313.3±33.5pg/ml respectively,showed the concentration of MSAP and SAP group were higher than the MAP group,there were the difference statistically significant(P<0.05).3 Comparison on the dynamic change concentration of IL-6 in the serm of the MAP group,MSAP and SAP group at the diffrent time.The concentration of IL-6 in the serm of the MAP group,MSAP and SAP group in 1 day,3 day,7 day,10 day: The concentration of IL-6 in the serm of the MAP group were 12.95±1.22pg/ml ? 15.83±1.68pg/ml ? 18.62±1.36pg/ml ?17.64±1.40pg/ml respctively;The concentration of IL-6 in the serm of the MAP and SAP group were 21.32±2.31pg/ml ? 22.85±3.18pg/ml ?25.92±2.33pg/ml?24.10±2.33pg/ml respectively,showed the concentration of MSAP and SAP group were higher than the MAP group,there were the difference statistically significant(P<0.05).4 Comparison on the dynamic change concentration of CRP in the serm of the MAP group,MSAP and SAP group at the diffrent time.The concentration of CRP in the serm of the MAP group,MSAP and SAP group in 1 day,3 day,7 day,10 day: The concentration of CRP in the serm of the MAP group were 7.35±0.39 mg/L?9.11±0.60 mg/L ?14.03±1.11 mg/L?13.32±1.73 mg/L respectively,The concentration of CRP in the serm of the MAP and SAP group were 11.36±0.60 mg/L?14.10±1.20 mg/L?18.38±1.12 mg/L?14.19±0.62 mg/L respectively,showed the concentration of MSAP and SAP group were higher than the MAP group,there were the difference statistically significant(P<0.05).Conclusion:1 The concentration of substance P,IL-6 and CRP in the serum of patients with acute pancreatitis were significantly higher than those of healthy people,showed the three substances were involved in the inflammatory response.2 The concentration of substance P,IL-6 and CRP in the serum of MSAP and SAP group were obviously higher than those of MAP group,showed that the higher the concentration,the more serious the illness.3 With the extension of time,concentration of substance P,IL-6 and CRP in the serum of patients with acute pancreatitis were increased,they reached the peaks in the seventh day after admission.The peaks of severe patient were higher than the peaks of Mild patients.Then the concentration of substance P,IL-6 and CRP were decreased,showed that the symptoms of the patients were from severe to mild.4 Combined detection of concentrations of substance P,IL-6 and CRP in the serum,it is important to predict condition changes of patients with acute pancreatitis and to guide the clinical classification,and develop diagnosis and treatment method.