急性胰腺炎患者早期血清D-乳酸、内毒素及二胺氧化酶在病情评估中的价值  

Value of serum D-lactate, endotoxin and diamine oxidase in assessment of the early stage of acute pancreatitis

作　　者：龚玉婷 黄丹 陈志芬[1] GONG Yuting;HUANG Dan;CHEN Zhifen(Dept.of Gastroenterology,Zhongnan Hospital of Wuhan University)

机构地区：[1]武汉大学中南医院消化内科/湖北省肠病医学临床研究中心/湖北省肠病重点实验室

出　　处：《武汉大学学报（医学版）》2019年第1期112-115,共4页Medical Journal of Wuhan University

基　　金：国家自然科学基金资助项目(编号:81770283;81072152);湖北省自然科学基金资助项目(编号:2011CDB531)

摘　　要：目的:探讨急性胰腺炎(AP)患者早期血清D-乳酸、内毒素、二胺氧化酶(DAO)与病情严重程度的关系。方法:收集2016年12月-2018年1月武汉大学中南医院消化内科诊治的AP患者资料,根据患者病情严重程度分为轻度AP(MAP)组78例、重度AP(SAP)组46例,并收集60例体检健康者作为对照组。比较3组间D-乳酸、内毒素及DAO水平的差异及与病情严重程度的相关性,并用ROC曲线分析预测上述指标评估病情严重程度的灵敏度与特异度。结果:MAP组D-乳酸、内毒素及DAO水平分别为(39.26±11.55)mg/L、(23.57±14.59)U/L、(23.06±18.68)U/L低于SAP组的(52.10±15.83)mg/L、(28.26±10.32)U/L、(52.24±31.58)U/L;高于对照组的(28.87±11.88)mg/L、(5.54±4.52)U/L、(9.66±6.24)U/L,差异有统计学意义(P<0.05)。Spearman相关分析显示以上指标与AP严重程度呈正相关(P<0.05);ROC曲线示D-乳酸、内毒素和DAO的曲线下面积分别为0.737、0.574、0.790。结论:早期血清D-乳酸、内毒素、DAO与AP严重程度明显相关,对预测急性胰腺炎病情进展有一定的临床意义。Objective: To investigate the relationship between serum D-lactic acid, endotoxin, diamine oxidase(DAO) and the severity of the disease in early stage of acute pancreatitis(AP). Methods: A total of 124 patients with acute pancreatitis were collected from December 2016 through January 2018 for retrospective analysis. According to the severity of AP, the patients were divided into mild AP(MAP)group with 78 patients and severe AP(SAP) group with 46 patients, moreover, 60 people of physical health was as control group. The differences of serum D-lactate, endotoxin and DAO among the three groups were compared. The sensitivity and specificity of the above indicators to assess the severity of the AP were predicted by ROC curve. Results: The levels of D-lactic acid, endotoxin and DAO inMAP group([39.26 ± 11.55] mg/L, [23.57 ± 14.59] U/L and [23.06 ± 18.68] U/L, respectively)were lower than those of SAP group([52.10 ± 15.83] mg/L, [28.26 ± 10.32] U/L, and [52.24 ±31.58] U/L, respectively, all P<0.05), but were higher than the control group([28.87± 11.88] mg/L, [5.54± 4.52] U/L, and [9.66± 6.24] U/L, respectively, all P<0.05), and the differences were statistically significant. Spearman correlation analysis showed that the above indicators were positively correlated with the severity of AP(P<0.05). ROC curve showed that the areas under the curve of Dlactic acid, endotoxin and DAO were 0.737, 0.574, and 0.790, respectively. Conclusion: Serum D-lactic acid, endotoxin and DAO are significantly correlated with the early severity of AP, which has a certain clinical significance in predicting the progression of acute pancreatitis.

关 键 词：急性胰腺炎 D-乳酸 内毒素 二胺氧化酶 

分 类 号：R576[医药卫生—消化系统]