摘要
目的:探究血清载脂蛋白B(ApoB)与载脂蛋白A1(ApoA1)的比值(ApoB/ApoA1)、脂蛋白a[Lp(a)]及脂肪酶(LPS)水平预测重症急性胰腺炎(SAP)的价值。方法:选取2019年6月至2021年6月我院收治的急性胰腺炎(AP)患者246例,根据病情严重程度分为轻症急性胰腺炎(MAP)组(n=89)、中度重症急性胰腺炎(MSAP)组(n=103)和SAP组(n=54)。比较3组患者的一般资料、急性生理学与慢性健康状况评分Ⅱ(APACHEⅡ)、改良CT评分(MCTSI)、Ranson评分;入院即刻采集静脉血,检测3组患者血生化指标及血清ApoB、ApoA1、Lp(a)和LPS水平。采用ROC曲线评估ApoB/ApoA1、Lp(a)、LPS预测SAP的价值。结果:3组患者一般资料比较差异无统计学意义,但APACHEⅡ、MCTSI和Ranson评分随AP严重程度的升高而升高(P<0.05)。3组患者TC、TG、HDL、LDL相比,差异无统计学意义,而血清ApoB/ApoA1、Lp(a)和LPS水平相比,差异有统计学意义,且随AP严重程度的升高而升高(P<0.05)。发病48 h内ApoB/ApoA1、Lp(a)、LPS预测SAP的AUC(95%CI)分别为0.844(0.742~0.946)、0.763(0.647~0.879)和0.808(0.682~0.935)。结论:发病48 h内血清ApoB/ApoA1、Lp(a)和LPS水平可用于SAP的早期预测。
Aim:To investigate the value of serum apolipoprotein B(ApoB) to apolipoprotein A1(ApoA1) ratio(ApoB/ApoA1),lipoprotein a [Lp(a)] and lipase(LPS) levels in predicting severe acute pancreatitis(SAP).Methods:A total of 246 patients with acute pancreatitis(AP) admitted to our hospital from June 2019 to June 2021 were chosen and allocated into mild AP(MAP) group(n=89),moderately severe AP(MSAP) group(n=103),and SAP group(n=54).The general data,acute physiology and chronic health evaluation Ⅱ( APACHE Ⅱ) score,modified CT severity index( MCTSI) score,and Ranson score of the 3 groups were collected.Fasting venous blood samples were collected at admission to determine serum biochemical indicators,serum Apo B,Apo A1,Lp( a) and LPS levels.ROC curve was used to assess the value of Apo B/Apo A1,Lp( a) and LPS in predicting SAP.Results:There was no significant difference in general data among the3 groups.APACHE Ⅱ score,MCTSI score and Ranson score increased with the aggravation of AP( P < 0.05).There was no significant difference in TC,TG,HDL or LDL among the 3 groups,but there were significant differences in Apo B/Apo A1,Lp( a) and LPS levels,which showed an increasing trend with the aggravation of AP( P < 0.05).AUC( 95% CI) of Apo B/Apo A1,Lp( a),and LPS within 48 hours after onset to evaluate SAP were 0.844( 0.742-0.946),0.763( 0.647-0.879),and 0.808( 0.682-0.935),respectively.Conclusion:Serum Apo B/Apo A1,Lp( a) and LPS levels within 48hours after onset can be used for early predicting of SAP.
作者
赵凯
韩思静
任书勤
章阳
ZHAO Kai;HAN Sijing;REN Shuqin;ZHANG Yang(Department of Gastroenterology,the Second Affiliated Hospital of Chengdu Medical College(China National Nuclear Corporation 416 Hospital),Chengdu 610051)
出处
《郑州大学学报（医学版）》
CAS
北大核心
2022年第6期849-853,共5页
Journal of Zhengzhou University(Medical Sciences)
基金
四川省卫生和计划生育委员会科研课题(18PJ395)。
作者简介
通信作者:章阳,女,1962年6月生,本科,主任医师,研究方向:消化内科。
