摘要
目的探讨血清半乳糖凝集素3(Gal-3)、血清诱捕受体3(DcR3)和淀粉样蛋白A(SAA)在急性胰腺炎(AP)患者病情严重程度评估及预后预测中的临床价值。方法选取2020年10月-2022年9月在民航总医院进行治疗的AP患者116例作为研究对象,根据病情严重程度分为轻度组(MAP组)45例、中度组(MSAP组)38例和重度组(SAP组)33例,根据28 d预后情况分为生存组94例、死亡组22例。采用酶联免疫吸附法检测AP患者血清Gal-3、DcR3和SAA水平,比较各组血清Gal-3、DcR3、SAA水平和急性生理学与慢性健康状况(APACHEⅡ)评分;采用Pearson相关性分析APACHEⅡ评分与患者血清Gal-3、DcR3和SAA水平的关系;采用logistic回归分析AP患者病情严重程度的影响因素;采用受试者工作特征(ROC)曲线分析血清Gal-3、DcR3和SAA水平对评估SAP患者预后情况的价值。结果MAP、MSAP、SAP组患者血清Gal-3、DcR3、SAA水平和APACHEⅡ评分依次升高,且各组间比较差异均有统计学意义(F=74.438、73.063、162.479、83.572,P均<0.001)。AP患者APACHEⅡ评分与Gal-3、DcR3、SAA水平均成正相关(r=0.552、0.584、0.641,P均<0.001)。血清Gal-3、DcR3、SAA水平均为AP患者病情严重程度的影响因素(P=0.025、0.006、0.001)。生存组患者血清Gal-3、DcR3、SAA、C反应蛋白、白细胞计数、淀粉酶和白细胞介素6水平均显著低于死亡组,差异均有统计学意义(t=7.006、6.176、3.001、13.546、9.794、14.008、16.191,P均<0.01)。Gal-3、DcR3、SAA三者联合评估AP患者预后的曲线下面积为0.919,敏感性为86.36%,特异性为88.30%。结论血清Gal-3、DcR3和SAA水平可较好地反映AP患者病情严重程度,且三者联合检测对预测AP患者预后情况具有较高的价值。
Objective To investigate the clinical value of serum galectin 3(Gal-3),serum decoy receptor 3(DcR3)and serum amyloid A(SAA)in evaluating the severity of the disease and predicting the prognosis of patients with acute pancreatitis(AP).Methods A total of 116 AP patients who were treated in our hospital from October 2020 to September 2022 were selected as the study subjects,according to the severity of the disease,45 patients were included into mild group(MAP group),38 patients into moderate group(MSAP group)and 33 patients into severe group(SAP group);according to the 28 day prognosis,94 patients were divided into survival group and 22 patients into death group.The levels of serum Gal-3,DcR3 and SAA in AP patients were detected by enzyme-linked immunosorbent assay;the levels of serum Gal-3,DcR3,SAA and the scores of acute physiology and chronic health evaluationⅡ(APACHEⅡ)of AP patients in each group were compared;Pearson correlation analysis was used to analyze the relationship between APACHEⅡscore and serum Gal-3,DcR3 and SAA levels;logistic regression was used to analyze the influencing factors of the severity of AP patients;receiver operating characteristic(ROC)curve was used to analyze the value of serum Gal-3,DcR3 and SAA levels in evaluating the prognosis of SAP patients.Results The levels of serum Gal-3,DcR3,SAA,and APACHEⅡscore in MAP,MSAP and SAP groups increased in turn(F=74.438,73.063,162.479,83.572;all P<0.001);APACHEⅡscore of AP patients was positively correlated with Gal-3,DcR3 and SAA levels(r=0.552,0.584,0.641,all P<0.001);serum Gal-3,DcR3 and SAA levels were the influencing factors of the severity of AP patients(P=0.025,0.006,0.001);the levels of serum Gal-3,DcR3,SAA,CRP,WBC,AMY and IL-6 in survival group were obviously lower than those in death group(t=7.006,6.176,3.001,13.546,9.794,14.008,16.191,all P<0.01);the area under the curve of Gal-3,DcR3 combined with SAA to evaluate the prognosis of AP patients was 0.919,the sensitivity was 86.36%,and the specificity was 88.30%.Conclusion The serum levels of Gal-3,DcR3 and SAA could better reflect the severity of the disease in patients with AP,and the combined detection of the three has a high value in predicting the prognosis of patients with AP.
作者
张亚楠
杨帅
李源培
豆亚静
马洪庆
ZHANG Yanan;YANG Shuai;LI Yuanpei;DOU Yajing;MA Hongqing(Department of Emergency,Civil Aviation General Hospital,Beijing 100123,China;Department of General Surgery,the Fourth Hospital of Hebei Medical University,Shijiazhuang,Hebei 051000,China)
出处
《热带医学杂志》
CAS
2023年第10期1397-1401,1422,共6页
Journal of Tropical Medicine
基金
河北省医学科学研究课题计划(20220142)
作者简介
张亚楠(1987-),女,硕士研究生,住院医师,从事肺栓塞、脓毒症、急性胰腺炎临床研究工作;通信作者:马洪庆,E-mail:hongqingma555@163.com
