[1]陆卫华,邬 明,方 庆,等.早期低维生素C水平对急性胰腺炎病人免疫功能和临床预后的影响[J].肠外与肠内营养杂志,2020,(06):330-334.[doi:10.16151/j.1007-810x.2020.06.003]
 LU Wei-hua,WU Ming,FANG Qing,et al.The effects of low serum Vitamin C levels in early stage on immune function and clinical outcomes in acute pancreatitis patients[J].PARENTERAL & ENTERAL NUTRITION,2020,(06):330-334.[doi:10.16151/j.1007-810x.2020.06.003]
点击复制

早期低维生素C水平对急性胰腺炎病人免疫功能和临床预后的影响
分享到:

《肠外与肠内营养》杂志[ISSN:1007-810X/CN:32-1477/R]

卷:
期数:
2020年06期
页码:
330-334
栏目:
论著
出版日期:
2020-11-10

文章信息/Info

Title:
The effects of low serum Vitamin C levels in early stage on immune function and clinical outcomes in acute pancreatitis patients
作者:
陆卫华邬 明方 庆林 莉唐忠志
中国人民解放军中部战区总医院急诊科,湖北武汉 430070
Author(s):
LU Wei-hua WU Ming FANG Qing LIN Li TANG Zhong-zhi
Department of Emergency, General Hospital of PLA Central Theater Command, Wuhan 430070,Hubei, China
关键词:
急性胰腺炎 维生素C 免疫功能 胰腺坏死 临床预后
Keywords:
Acute pancreatitis Vitamin C Immune function Pancreatic necrosis Clinical outcomes
分类号:
R605
DOI:
10.16151/j.1007-810x.2020.06.003
文献标志码:
A
摘要:
目的:本研究旨在探究早期低维生素C水平对急性胰腺炎(AP)病人免疫功能和临床预后的影响。方法:前瞻性观察性研究,纳入2018年1月~2019年6月入住我院的胰腺炎病人的临床数据,经过纳排标准后,最终有34例病人纳入正常维生素C水平组,30例病人纳入低维生素C水平组。统计并分析病人的一般临床资料、主要免疫指标、炎症指标以及临床预后。 结果:在基线数据方面,两组之间没有显著差异,但低维生素C水平组病人疾病严重程度更高;血清学指标中,相比于正常组,低维生素 C 水平组病人血清炎症介质 IL-6 水平更高,免疫指标IgA, IgG, CD4+ T细胞比例,CD4+/ CD8+比值等均显著较低;在临床预后方面,低维生素C水平组的AP病人器官功能障碍和胰腺坏死发生比例更高;Logist回归分析显示低维生素C水平是重型急性胰腺炎(SAP)发生的重要独立危险因素。 结论:低维生素C水平与AP病人的免疫功能受损以及不良临床预后密切相关,是预测SAP发生的重要因素之一。
Abstract:
Objective: The aim of this study was to investigate the effects of low serum vitamin C levels in early stage on immune function and clinical outcomes in patients with acute pancreatitis (AP). Methods: A prospective observational study of AP patients admitted to our hospital from January 2018 to June 2019 was performed. After inclusion and exclusion, thirty-four patients were eventually enrolled in the control group and 30 patients in the low vitamin C group (study group). The demographic characteristics, serum immune parameters as well as clinical outcomes of included patients were recorded and analyzed. Results: In terms of baseline data, the disease severity of AP in the study group was severer and more patients suffered from severe form of acute pancteatitis (SAP). In immune function associated parameters, the serum IgA, IgG levels, CD4+ T percentage, as well as CD4+/ CD8+ ratio were significantly lower in the study group compared with the control group. As to in-hospital clinical outcomes, patients in the study group had higher incidence of organ failure and pancreatic necrosis than that in the control group. The further logistic regression analysis showed that low serum vitamin C level was an independent and significant risk factor for the occurrence of SAP. Conclusion: Low serum vitamin C level was strongly associated with immune dysfunction and poor clinical outcomes in AP patients, which could function as a significant predictive factor for SAP.

参考文献/References:


[1] Forsmark CE, Vege SS, Wilcox CM. Acute Pancreatitis. N Engl J Med, 2017, 376(6):598-599.
[2] Booth DM, Mukherjee R, Sutton R, et al. Calcium and reactive oxygen species in acute pancreatitis: friend or foe? Antioxid Redox Signal, 2011, 15(10):2683-2698.
[3] 陈 晨, 张久之, 万献尧. 大剂量维生素C在脓毒症中的应用.中华内科杂志,2019,58( 3 ): 233-236.
[4] Scott P, Bruce C, Schofield D, et al. Vitamin C status in patients with acute pancreatitis. Br J Surg, 1993, 80(6):750-754.
[5] Banks PA, Bollen TL, Dervenis C, et al. Classification of acute pancreatitis--2012: revision of the Atlanta classification and definitions by international consensus. Gut, 2013, 62(1):102-111.
[6] Abu Omar Y, Attar BM, Agrawal R,et al.Revised Marshall Score: A New Approach to Stratifying the Severity of Acute Pancreatitis. Dig Dis Sci, 2019,64(12)3610-3615.
[7] Working Group IAP/APA Acute Pancreatitis Guidelines. IAP/APA evidence-based guidelines for the management of acute pancreatitis. Pancreatology, 2013,13(4 Suppl 2):e1-15.
[8] Habtezion A. Inflammation in acute and chronic pancreatitis. Curr Opin Gastroenterol. 2015,31(5):395-399.
[9] Bone RC. Sir Isaac Newton, sepsis, SIRS, and CARS. Crit Care Med, 1996,24(7):1125-1128.
[10] Castellino F, Germain RN. Cooperation between CD4+ and CD8+ T cells: when, where, and how. Annu Rev Immunol, 2006,24:519-540.

相似文献/References:

[1]林 宁,孙红玉,陈 亭,等.膳食纤维在急性胰腺炎治疗中的作用[J].肠外与肠内营养杂志,2018,(05):265.[doi:10.16151/j.1007-810x.2018.05.003]
[2]杨 军,秦 勤,王 田,等.极早期进食对急性胰腺炎病人临床结局的影响[J].肠外与肠内营养杂志,2018,(05):302.[doi:10.16151/j.1007-810x.2018.05.011]
 YANG Jun,QIN Qin,WANG Tian,et al.Effect of very early feeding on clinical outcomes in patients with mild acute pancreatitis[J].PARENTERAL & ENTERAL NUTRITION,2018,(06):302.[doi:10.16151/j.1007-810x.2018.05.011]
[3]吕 慧,李山林,周洪涛,等.早期肠内营养对急性胰腺炎病人内外分泌功能和远期生活质量的影响[J].肠外与肠内营养杂志,2020,(01):33.[doi:DOI : 10.16151/j.1007-810x.2020.01.008]
 L? Hui,LI Shan-lin,ZHOU Hong-tao.The effects of early eternal nutrition on pancreatic endocrine/exocrine functions and long-term quality of life in acute pancreatitis patients[J].PARENTERAL & ENTERAL NUTRITION,2020,(06):33.[doi:DOI : 10.16151/j.1007-810x.2020.01.008]
[4]程 飞,翁延宏,陈 伟.早期肠内营养在急性胰腺炎病人中的应用分析[J].肠外与肠内营养杂志,2022,(03):150.[doi:DOI : 10.16151/j.1007-810x.2022.03.005]
 CHENG Fei,WENG Yan-hong,CHEN Wei.Application of early enteral nutrition in acute pancreatitis[J].PARENTERAL & ENTERAL NUTRITION,2022,(06):150.[doi:DOI : 10.16151/j.1007-810x.2022.03.005]
[5]许 尧,袁晨晨,马孝杰,等.血清铁与急性胰腺炎病人预后的相关性研究[J].肠外与肠内营养杂志,2023,(01):25.[doi:DOI : 10.16151/j.1007-810x.2023.01.008]
 XU Yao,YUAN Chen-chen,MA Xiao-jie,et al.Association between serum iron levels and prognosis in patients with acute pancreatitis[J].PARENTERAL & ENTERAL NUTRITION,2023,(06):25.[doi:DOI : 10.16151/j.1007-810x.2023.01.008]

备注/Memo

备注/Memo:
作者简介 :陆卫华,副主任医师,医学博士,主要从事急危重症的研究工作。E-mail:luweihualwh@icloud.com 通讯作者 :唐忠志,E-mail:64135789@qq.com
更新日期/Last Update: 1900-01-01