Mustafa Ekici, Gülşah Çıkrıkçı Işık, Özge Ebru Dağcı Varhan, Ş. K. Çorbacıoğlu, Y. Çevik
Objective: Reactive oxygen radicals are generated in the early stages of acute pancreatitis (AP) and are responsible for its progression. Thiol/disulfide homeostasis (TDH) is an important antioxidative mechanism. This study aimed to evaluate the role of TDH in the differential diagnosis of AP and predict its clinical severity. Methods: Patients admitted to the emergency department due to upper abdominal pain were evaluated. The study consisted of two groups: the AP group and the non-AP group (patients with diagnoses other than AP). The AP group was divided into mild and severe according to Acute physiology and chronic health evaluation II (APACHE-II) scores. TDH was measured with an automated assay from Erel et al. Statistical analyses were done with SPSS 16.0. Results: The results from 128 cases—58 in the AP group and 70 in the non-AP group—were evaluated. There was no difference in TDH parameters between the AP and non-AP groups. Among the AP subgroups, native thiol (sh) and total thiol (tt) were significantly lower in the severe AP group (sh: 313.9 μmol/L, 239.1 μmol/L; tt: 351.5 μmol/L, 303 μmo/L, respectively, in the mild and severe AP groups, P-value=0.006, P-value=0.013). Conclusion: TDH parameters change because of inflammatory processes in AP. Since this change does not occur for any specific reason, using TDH parameters for differential diagnosis of AP in patients with upper abdominal pain is not appropriate. However, in patients already diagnosed with AP, native and total thiol levels might be helpful in the prediction of clinical severity with a limited role.
目的：急性胰腺炎（AP）早期会产生活性氧自由基，并导致病情恶化。硫醇/二硫化物平衡（TDH）是一种重要的抗氧化机制。本研究旨在评估 TDH 在鉴别诊断急性胰腺炎中的作用，并预测其临床严重程度。 研究方法对因上腹部疼痛到急诊科就诊的患者进行评估。研究包括两组：AP 组和非 AP 组（诊断为 AP 以外的患者）。AP 组根据急性生理学和慢性健康评估 II（APACHE-II）评分分为轻度和重度 AP 组。TDH 采用 Erel 等人的自动测定法进行测量。统计分析采用 SPSS 16.0 进行。结果评估了 128 个病例的结果，其中 AP 组 58 例，非 AP 组 70 例。AP 组和非 AP 组的 TDH 参数没有差异。在 AP 亚组中，轻度和重度 AP 组的原生硫醇（sh）和总硫醇（tt）明显低于 AP 组（sh：313.9 μmol/L，239.1 μmol/L；tt：351.5 μmol/L，303 μmo/L，P 值=0.006，P 值=0.013）。结论AP 中的 TDH 参数会因炎症过程而发生变化。由于这种变化的发生没有任何特殊原因，因此使用 TDH 参数对上腹部疼痛患者进行 AP 鉴别诊断并不合适。不过，对于已确诊为 AP 的患者，原生硫醇和总硫醇水平可能有助于预测临床严重程度，但作用有限。
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