血清瓜氨酸评估急性胰腺炎患者肠屏障功能障碍  

Serum citrulline concentration used for assessing intestinal barrier dysfunction in patients with acute pancreatitis

作　　者：孔灿 吴怡 李树民[3,4,5] 岑云云 孙大力[3,4,5] 李为明 梁显军[1] 徐鹏远 KONG Can;WU Yi;LI Shu-min;CEN Yun-Yun;SUN Da-Li;LI Wei-ming;LIANG Xian-Jun;XU Peng-Yuan(Department of Gastrointestinal Surgery, Taizhou Central Hospital/ Taizhou University Hospital, TaiZhou, Zhejiang 318000, China;Experimental Center for Medical Science Research of Kunming Medical University;Department of Gastrointestinal Surgery, Second Affiliated Hospital of Kunming Medical University;Research Center for Surgical Clinical Nutrition in Yunnan Province;Professor Yang Hua Research Station in Yunnan Province, Kunming 650101, China)

机构地区：[1]台州市中心医院/台州学院附属医院胃肠外科,浙江台州318000 [2]昆明医科大学科研实验中心 [3]昆明医科大学第二附属医院胃肠外科二病区 [4]云南省外科临床营养研究中心 [5]云南省院士(专家)工作站--杨桦专家工作站,云南昆明650500

出　　处：《肝胆胰外科杂志》2019年第1期26-29,共4页Journal of Hepatopancreatobiliary Surgery

基　　金：云南省院士(专家)工作站--杨桦专家工作站基金项目(2015IC034)

摘　　要：目的探讨血清瓜氨酸浓度在急性胰腺炎患者肠屏障功能障碍评估中的应用价值。方法回顾性分析2016年3月至2017年5月期间昆明医科大学第二附属医院胃肠外科二病区收治的发病1周以内的急性胰腺炎患者27例作为AP组,纳入同期健康成年人30例作为正常对照组。AP组再分为肠屏障功能障碍组(11例)及非肠屏障功能障碍组(16例)2个亚组。检测各组外周血清瓜氨酸浓度,将其与AP组肠屏障功能障碍的发生进行相关性研究。结果瓜氨酸浓度:对照组(29.59±10.37)μmol/L,AP组(23.20±9.85)μmol/L,两组差异有统计学意义(P <0.05)。肠屏障功能障碍组(15.47±5.80)μmol/L,非肠屏障功能障碍组(28.51±8.48)μmol/L,两组差异有统计学意义(P <0.001)。根据ROC结果,血清瓜氨酸临床拟诊肠屏障功能障碍最佳临界值为:21.67μmol/L;灵敏度:0.818(95%CI=48.2～97.7);特异度:0.875(95%CI=61.7～98.4)。结论外周血瓜氨酸水平降低可作为评估急性胰腺炎患者肠屏障功能障碍的一项生物学指标。Objective To investigate the value of serum citrulline concentration in the evaluation of intestinal barrier dysfunction in patients with acute pancreatitis (AP). Methods A retrospective analysis was done in this study. Total of 27 patients with AP onset within 1 week were admitted in Department of Gastrointestinal Surgery, the Second Affiliated Hospital of Kunming Medical University between Mar. 2016 and May 2017. AP patients were taken as the AP group, and 30 healthy abults were taken as normal control group. The AP group was further divided into two groups: the intestinal barrier dysfunction group (11 cases) and the non-intestinal barrier dysfunction group (16 cases). Peripheral serum citrulline concentration was measured and the correlation with the occurrence of intestinal barrier dysfunction in the AP group was explored. Results The concentration of citrulline in the control group was (29.59±10.37)μmol/L and (23.20±9.85)μmol/L in the AP group, the difference was statistically significant ( P <0.05). Intestinal barrier dysfunction group was (15.47±5.80)μmol/L, and non-intestinal barrier dysfunction group was (28.51±8.48)μmol/L, the difference was statistically significant ( P <0.001). According to the ROC results, the optimal threshold for the diagnosis of intestinal barrier dysfunction in serum citrulline was 21.67 μmol/L; sensitivity: 0.818 (95% CI =48.2~97.7); specificity: 0.875 (95% CI =61.7~98.4). Conclusion Decreased peripheral blood citrulline level can be used as a biological indicator for evaluating intestinal barrier dysfunction in patients with acute pancreatitis.

关 键 词：瓜氨酸 急性胰腺炎 肠屏障功能障碍 

分 类 号：R657.51[医药卫生—外科学]