吲哚美辛对内镜下逆行胆胰管造影术后外周血辅助性T细胞的影响

杨清峰; 王华冠; 韩亮; 雷家才; 黄海涛; 燕善军

doi:10.16766/j.cnki.issn.1674-4152.002500

吲哚美辛对内镜下逆行胆胰管造影术后外周血辅助性T细胞的影响

doi: 10.16766/j.cnki.issn.1674-4152.002500

1.
杭州市第九人民医院消化内科, 浙江杭州 311225
2.
杭州市第一人民医院消化内科, 浙江杭州 310003
3.
蚌埠医学院第一附属医院消化内科, 安徽蚌埠 233004

基金项目:

浙江省医药卫生科技计划项目 2020KY704

杭州市卫生科技计划项目 B20200616

详细信息

通讯作者:
杨清峰, E-mail: yangqingfeng7499@sina.com

中图分类号: R575.7 R576
计量
- 文章访问数: 203
- HTML全文浏览量: 86
- PDF下载量: 1
- 被引次数: 0
出版历程
- 收稿日期: 2021-03-24
- 网络出版日期: 2022-09-21

Effect of indomethacin on helper T cells in peripheral blood after endoscopic retrograde cholangiopancreatography

1.
Department of Gastroenterology, Hangzhou Ninth People ' s Hospital, Hangzhou, Zhejiang 311225, China

摘要

摘要: 目的探讨吲哚美辛栓纳肛对预防内镜下逆行胆胰管造影术(ERCP)后胰腺炎(PEP)可能的细胞学机制。方法选择2017年3-10月在蚌埠医学院第一附属医院消化内科住院并拟行ERCP术的患者40例, 按随机数字表法随机分为观察组和对照组, 每组20例, 分别检测2组患者ERCP术前及术后12 h外周静脉血调节性T细胞(Treg)、辅助性T细胞17型(Th17)及Treg/Th17值。结果对照组: 术前Treg、Th17、Treg/Th17分别为2.94(1.52, 3.71)%、1.42(0.87, 4.47)%、1.57(0.69, 2.88), 术后分别为1.92(1.22, 3.25)%、2.02(1.12, 4.93)%、0.77(0.37, 1.75), 术前术后比较差异均有统计学意义。观察组: 术前Treg、Th17、Treg/Th17分别为1.57(0.97, 2.37)%、1.92(1.27, 3.05)%、0.74(0.39, 2.28);术后分别为1.63(1.03, 1.86)%、2.26(1.36, 3.65)%、0.65(0.38, 1.64), 术前术后比较差异均无统计学意义。2组间除术前Treg差异有统计学意义外(Z=-2.259, P=0.024), 其余指标差异均无统计学意义。结论吲哚美辛栓纳肛预防ERCP术后PEP可能机制是维持Treg、Th17细胞免疫平衡, 使ERCP术后早期的炎症反应得到控制。
- 内镜下逆行性胰胆管造影 /
- 胰腺炎 /
- 调节性T细胞 /
- 辅助性T细胞17 /
- 吲哚美辛
Abstract: Objective To investigate the possible cytological mechanism of indomethacin suppository in the prevention of pancreatitis (PEP) after endoscopic retrograde cholangiopancreatography (ERCP). Methods Forty patients who were hospitalised in the Department of Gastroenterology of the First Affiliated Hospital of Bengbu Medical College from March 2017 to October 2017 and planned to undergo ERCP were randomly divided into the observation group and control group, with 20 cases in each group.The peripheral venous blood Treg, Th17 and Treg/Th17 values of the two groups were measured before and 12 h after ERCP. Results In the control group, the preoperative Treg, Th17 and Treg/Th17 values were 2.94(1.52, 3.71)%, 1.42(0.87, 4.47)% and 1.57(0.69, 2.88), and the postoperative values were 1.92(1.22, 3.25)%, 2.02(1.12, 4.93)% and 0.77(0.37, 1.75), respectively.There were significant differences in the preoperative and postoperative changes.In the observation group, the preoperative Treg, Th17 and Treg/Th17 values were 1.57(0.97, 2.37)%, 1.92(1.27, 3.05)% and 0.74(0.39, 2.28), and the postoperative values were 1.63(1.03, 1.86)%, 2.26(1.36, 3.65)% and 0.65(0.38, 1.64), respectively.There was no significant difference between the preoperative and postoperative changes.There was no significant difference in other indexes between the two groups except for the preoperative Treg difference (Z=-2.259, P=0.024). Conclusion The possible mechanism of indomethacin suppository in preventing PEP after ERCP is to maintain the immune balance of Treg and Th17 cells and control the early inflammatory response after ERCP.
- Endoscopic retrograde cholangiopancreatography /
- Pancreatitis /
- Regulatory T cell /
- Helper T cell 17 /
- Indomethacin

HTML全文

表 1 2组拟行ERCP术患者术前、术后12 h外周血Th17、Treg及Treg/Th17的比较[M(P₂₅, P₇₅)]

Table 1. Comparison of peripheral blood Th17, Treg and Treg/Th17 before and 12 h after ERCP between the two groups[M(P₂₅, P₇₅)]

组别	例数	Treg(%)		Th17(%)		Treg/Th17
组别	例数	术前	术后12 h	术前	术后12 h	术前	术后12 h
观察组	20	1.57(0.97，2.37)	1.63(1.03，1.86)	1.92(1.27，3.05)	2.26(1.36，3.65)	0.74(0.39，2.28)	0.65(0.38，1.64)
对照组	20	2.94(1.52，3.71)	1.92(1.22，3.25)^a	1.42(0.87，4.47)	2.02(1.12，4.93)^a	1.57(0.69，2.88)	0.77(0.37，1.75)^a
Z值		-2.259	-1.190	-0.514	-0.514	-1.542	-0.352
P值		0.024	0.234	0.607	0.607	0.123	0.725
注：与同组术前比较，^aP＜0.05。

下载: 导出CSV

参考文献(20)

[1]	胡旭军, 范燕萍, 尚敏杰. ERCP治疗高龄胆总管结石的疗效及对患者血清CA19-9和炎症水平的影响[J]. 中华全科医学, 2019, 17(1): 66-69. doi: 10.16766/j.cnki.issn.1674-4152.000601 HU X J, FAN Y P, SHANG M J. Curative effect of endoscopic retrograde cholangiopancreatography on elderly patients with choledocholithiasis and its effect on level of serum CA19-9 and inflammatory[J]. Chinese Journal of General Practice, 2019, 17(1): 66-69. doi: 10.16766/j.cnki.issn.1674-4152.000601
[2]	金晓昇, 陈璐茜, 季婷婷, 等. ERCP胆管支架置入治疗晚期恶性梗阻性黄疸的疗效研究[J]. 中华全科医学, 2018, 16(10): 1643-1645, 1649. doi: 10.16766/j.cnki.issn.1674-4152.000447 JIN X S, CHEN L X, JI T T, et al. Efficacy of insertion of bile duct stent through endoscopic retrograde cholangiopancreatography in the treatment of advanced stage malignant obstructive jaundice[J]. Chinese Journal of General Practice, 2018, 16(10): 1643-1645, 1649. doi: 10.16766/j.cnki.issn.1674-4152.000447
[3]	周庆, 王鸣, 吴丽丽. 鼻胆管引流术预防内镜逆行胰胆管造影术后胰腺炎的Meta分析[J]. 北京医学, 2017, 39(3): 232-235. https://www.cnki.com.cn/Article/CJFDTOTAL-BJYX201703002.htm ZHOU Q, WANG M, WU L L. Endoscopic nasobiliary drainage for the prevention of post-ERCP pancreatitis: A Meta-analysis[J]. Beijing Medical Journal, 2017, 39(3): 232-235. https://www.cnki.com.cn/Article/CJFDTOTAL-BJYX201703002.htm
[4]	陶涛, 张明, 张启杰, 等. 胰管支架预防胆总管结石ERCP术后并发症的临床研究[J]. 中华全科医学, 2019, 17(9): 1439-1442. doi: 10.16766/j.cnki.issn.1674-4152.000964 TAO T, ZHANG M, ZHANG Q J, et al. Using pancreatic stent to prevent complications after ERCP for common bile duct stones[J]. Chinese Journal of General Practice, 2019, 17(9): 1439-1442. doi: 10.16766/j.cnki.issn.1674-4152.000964
[5]	陈鹏, 缪林, 葛贤秀, 等. 肾上腺素对内镜逆行胰胆管造影高危因素患者术后胰腺炎的预防作用[J]. 中国临床研究, 2019, 32(6): 726-729. https://www.cnki.com.cn/Article/CJFDTOTAL-ZGCK201906002.htm CHEN P, MIAO L, GE X X, et al. Preventive effect of epinephrine on post-ERCP pancreatitis in patients with high risk factors[J]. Chinese Journal of Clinical Research, 2019, 32(6): 726-729. https://www.cnki.com.cn/Article/CJFDTOTAL-ZGCK201906002.htm
[6]	NIKHIL R T, MICHAEL L K. Emerging therapies to prevent post-ERCP pancreatitis[J]. Curr Gastroenterol Rep, 2020, 22(12): 59. doi: 10.1007/s11894-020-00796-w
[7]	MURAT P. Post-endoscopic retrograde cholangiopancreatography pancreatitis: A systematic review for prevention and treatment[J]. World J Gastroenterol, 2019, 25(29): 4019-4042. doi: 10.3748/wjg.v25.i29.4019
[8]	刘姗姗, 宋吉涛, 许军. 内镜下逆行胰胆管造影术后胰腺炎的诊断与防治进展[J]. 胃肠病学和肝病学杂志, 2019, 28(6): 714-718. doi: 10.3969/j.issn.1006-5709.2019.06.027 LIU S S, SONG J T, XU J. Progress in the diagnosis and prevention of post-endoscopic retrograde cholangio-pancreatography pancreatitis[J]. Chinese Journal of Gastroenterology and Hepatology, 2019, 28(6): 714-718. doi: 10.3969/j.issn.1006-5709.2019.06.027
[9]	张文杰, 陶怡菁, 全志伟. ERCP术后胰腺炎的预防[J]. 中华消化内镜杂志, 2010, 27(12): 670-672. https://www.cnki.com.cn/Article/CJFDTOTAL-XDLH200604019.htm ZHANG W J, TAO Y J, QUAN Z W. Prevention of pancreatitis after ERCP[J]. Chinese Journal of Digestive Endoscopy, 2010, 27(12): 670-672. https://www.cnki.com.cn/Article/CJFDTOTAL-XDLH200604019.htm
[10]	宗鹏飞, 汤茂春, 赵严. Th1、Th17细胞在急性胰腺炎中的研究进展[J]. 中华胰腺病杂志, 2017, 17(5): 352-354. doi: 10.3760/cma.j.issn.1674-1935.2017.05.019 ZONG P F, TANG M C, ZHAO Y. Research progress of Th1 and Th17 cells in acute pancreatitis[J]. Chinese Journal of Pancreatology, 2017, 17(5): 352-354. doi: 10.3760/cma.j.issn.1674-1935.2017.05.019
[11]	GAP R L. The balance of Th17 versus Treg cells in autoimmunity[J]. Int J Mol Sci, 2018, 19(3): 730. doi: 10.3390/ijms19030730
[12]	WEI C, WANG J Y, XIONG F, et al. Curcumin ameliorates DSS induced colitis in mice by regulating the Treg/Th17 signaling pathway[J]. Mol Med Rep, 2021, 23(1): 34.
[13]	PRADO D S, DAMASCENO L E A, SONEGO A B, et al. Pitavastatin ameliorates autoimmune neuroinflammation by regulating the Treg/Th17 cell balance through inhibition of mevalonate metabolism[J]. Int Immunopharmacol, 2021, 91: 107278. doi: 10.1016/j.intimp.2020.107278
[14]	XU D, XIE R L, XU Z W, et al. mTOR-Myc axis drives acinar-to-dendritic cell transition and the CD4 + T cell immune response in acute pancreatitis[J]. Cell Death Dis, 2020, 11(6): 416. doi: 10.1038/s41419-020-2517-x
[15]	GUO J G, LI Z, TANG D, et al. Th17/Treg imbalance in patients with severe acute pancreatitis: Attenuated by high-volume hemofiltration treatment[J]. Medicine (Baltimore), 2020. DOI: 10.1097/MD.0000000000021491.
[16]	THOMSON J E, BRAND M, FONTEH P. The immune imbalance in the second hit of pancreatitis is independent of IL-17A[J]. Pancreatology, 2018, 18(3): 246-252. doi: 10.1016/j.pan.2018.01.007
[17]	DAMIAN M, ELIZABETH M J, LINDSAY E N, et al. mPGES1-dependent Prostaglandin E₂ (PGE 2) controls antigen-specific Th17 and Th1 responses by regulating T autocrine and paracrine PGE2 production[J]. J Immunol, 2018, 200(2): 725-736. doi: 10.4049/jimmunol.1601808
[18]	KYOSHIRO T, TOMOAKI I, AKIRA S, et al. Molecular mechanisms underlying prostaglandin E₂-exacerbated inflammation and immune diseases[J]. Int Immunol, 2019, 31(9): 597-606. doi: 10.1093/intimm/dxz021
[19]	LI L S, GUAN K, ZHOU Y, et al. Prostaglandin E₂ signal inhibits T regulatory cell differentiation during allergic rhinitis inflammation through EP4 receptor[J]. World Allergy Organ J, 2019, 12(12): 100090. doi: 10.1016/j.waojou.2019.100090
[20]	HOOPER K M, KONG W, GANEA D. Prostaglandin E₂ inhibits Tr1 cell differentiation through suppression of c-Maf[J]. PLoS One, 2017, 12(6): e0179184. DOI: 10.1371/journal.pone.0179184.