鞘氨醇激酶-1、C-反应蛋白对急性胰腺炎严重程度的预测价值  

Value of Sphingosine Kinase 1 and C-reactive Protein in Prediction of Severity Degree of Acute Pancreatitis

作　　者：杨林[1] 钟明[2] 李永继[1] 郑晓博[1] 闫洪涛[1] 汤礼军[1] 黎冬暄[1] 

机构地区：[1]成都军区总医院全军普通外科中心,成都610083 [2]泸州医学院,四川泸州646000

出　　处：《解放军医药杂志》2014年第7期16-20,共5页Medical & Pharmaceutical Journal of Chinese People’s Liberation Army

基　　金：国家自然科学基金(81000185);四川省青年科技创新团队基金项目(2011JTD0010)

摘　　要：目的比较C-反应蛋白(CRP)和鞘氨醇激酶-1(SphK1)在预测急性胰腺炎(AP)严重程度方面的价值。方法选取2012年12月—2013年7月收治的30例AP患者,分为轻型AP(MAP)组17例和重型AP(SAP)组13例,另外纳入10例健康者作为健康对照组。AP患者在症状发生后、健康者在被选入组后48 h、72 h、5 d、7 d时分别检测血清CRP、外周血白细胞中SphK1 mRNA及其活性。结果 MAP组和SAP组患者血清CRP的水平、外周血白细胞中SphK1 mRNA、SphK1活性4个时间都高于健康对照组(P<0.05),但血清CRP的含量在MAP组和SAP组之间均无统计学差异(P>0.05)。48 h、72 h、5 d时,SAP组外周血白细胞中SphK1 mRNA、SphK1活性都高于MAP组(P<0.05);7 d时SAP组和MAP组的SphK1 mRNA、SphK1活性均无统计学差异(P>0.05)。在48 h时,SphK1的诊断灵敏度和诊断准确性最高,而且ROC曲线下面积高达0.946。结论在早期预测AP严重程度方面,与血清CRP相比,测定外周血白细胞中的SphK1是一个更好的方法。Objective To compare the forecasting value of C-reactive protein （CRP） and Sphingosine Kinase 1 （SphK1） in diagnosis of the severity of the acute pancreatitis （AP）. Methods A total of 30 patients with AP during De-cember 2012 and July 2013 were divided into severe acute pancreatitis group （SAP group, n =13） and mild acute pancrea-titis group （MAP group, n =17）. Ten healthy volunteers were selected as control group. The levels of serum CRP, SphK1 mRNA and SphK1 enzymatic activity of peripheral blood leucocyte were measured in AP patients at 48 h, 72 h, 5 d and 7 d after the attack of AP. Results At 48 h, 72 h, 5 d and 7 d, the levels of serum CRP, SphK1 mRNA and SphK1 enzy-matic activity of peripheral blood leucocyte in patients with MAP and SAP were elevated, compared with those in control group （P 〈0. 05）; while the difference in serum CRP level was not statistically significant between MAP and SAP groups （P ＆gt;0. 05）. The levels of SphK1 mRNA and SphK1 enzymatic activity of peripheral blood leucocyte in SAP patients were elevated, compared with those in MAP patients at 48 h, 72 h and 5 d （P 〈0. 05）; the differences in level of SphK1 mRNA and SphK1 enzymatic activity of peripheral blood leucocyte were not statistically significant at 7 d between MAP and SAP groups （P ＆gt;0. 05）. The highest sensitivity and diagnostic accuracy of SphK1 were observed at 48 h after the AP attack, and the area under ROC curve was up to 0. 946. Conclusion The value of measurement of SphK1 of peripheral blood leu-cocyte is preferred in the early prognosis of AP, compared with those by CRP.

关 键 词：胰腺炎 鞘氨醇激酶-1 C-反应蛋白 

分 类 号：R576.1[医药卫生—消化系统]