血清铁调素在急性胰腺炎患者中的临床价值  

Clinical significance of serum hepcidin in patients with acute pancreatitis

作　　者：沈阳[1] 薛成俊[1] 钟文贵[1] 陈志坚[1] 尤国莉 薛勇[2] 

机构地区：[1]南通大学附属建湖医院消化科,江苏省盐城市224700 [2]南通大学附属建湖医院检验科,江苏省盐城市224700

出　　处：《世界华人消化杂志》2016年第14期2236-2240,共5页World Chinese Journal of Digestology

基　　金：2014年盐城市医学科技发展计划基金资助项目;No YK2014098~~

摘　　要：目的:探讨血清铁调素(hepcidin,HEP)在急性胰腺炎(acute pancreatitis,AP)患者中的浓度变化和临床价值.方法:轻症急性胰腺炎(mild acute pancreatitis,MAP)104例、重症急性胰腺炎(severe acute pancreatitis,SAP)45例,分别于入院时、入院后1、3、7 d用酶联免疫分析法检测HEP浓度,以50例健康体检者为对照,分析HEP与A P的临床相关性,并绘制受试者工作特征曲线.结果:AP患者入院时HEP浓度高于对照组(P<0.05);入院后1、3、7 d SAP组HEP浓度高于MAP组(P<0.05);入院时轻症、SAP组间HEP浓度无明显差异;HEP与血清C反应蛋白、APACHE-Ⅱ评分浓度正相关(P=0.004、0.000),与血钙浓度负相关(P=0.003).以入院后第3天A P H E P浓度绘制的R O C曲线下面积为0.802,以H E P浓度大于133 ng/m L为临界值,以HEP诊断SAP的敏感度为95.6%,特异度为61.5%.结论:HEP与AP严重程度密切相关,可能成为AP病情监测以及SAP早期识别的重要指标.AIM：To investigate the changes of serum hepcidin in patients with acute pancreatitis and analyze its clinical significance.METHODS：Blood samples from 104 patients with mild acute pancreatitis,45 patients with severe acute pancreatitis and 50 healthy controls were collected,and serum hepcidin was measured by enzyme linked immunosorbent assay at admission,1,3,and 7 d after admission.The association of serum hepcidin with acute pancreatitis was analyzed.Receiver operating characteristic curve analysis was performed.RESULTS：The median concentration of serum hepcidin in patients with acute pancreatitis at admission was significantly higher than that in healthy controls（P〈0.05）.The differences in median concentrations of serum hepcidin between severe and mild acute pancreatitis were significant at 1,3,and 7 d after admission（P 0.05）,but not at admission.Correlation analysis showed that serum hepcidin was positively correlated with C-reactive protein levels and APACHE-Ⅱ score（P=0.004,0.000）,but was negatively correlated with serum calcium levels（P=0.003）.The area under the ROC curve of serum hepcidin in patients with severe acute pancreatitis and mild acute pancreatitis at 3 d after admission was 0.802.With a cutoff value of 133 ng/mL,the overall sensitivity was 95.6%,and specificity was 61.5%.CONCLUSION：Serum hepcidin correlates with the extent of pancreatitis.It can be used for monitoring the development of acute pancreatitis and may be a potential marker for early diagnosis of severe acute pancreatitis.

关 键 词：急性胰腺炎 重症急性胰腺炎 铁调素 

分 类 号：R576[医药卫生—消化系统]