急性胰腺炎患者血浆缺血修饰白蛋白水平变化及临床意义  

Changes and clinical significance of plasma ischemia-modified albumin in patients with acute pancreatitis

作　　者：王义刚[1] 黄婷[1] 冉恒泉[1] 汪俊州 孙雅轩 孙昌勤[1] 熊勇[1] WANG Yigang;HUANG Ting;RAN Hengquan;WANG Junzhou;SUN Yaxuan;SUN Changqin;XIONG Yong(Department of Hepatobiliary Surgery,Panzhihua Central Hospital,Sichuan Province,Panzhihua617000,China)

机构地区：[1]四川省攀枝花市中心医院肝胆外科,四川攀枝花617000

出　　处：《中国医药导报》2020年第22期21-24,28,共5页China Medical Herald

基　　金：四川省医学科研课题计划项目(S16048)。

摘　　要：目的探讨急性胰腺炎患者血浆缺血修饰白蛋白水平变化及临床意义。方法选择2017年2月—2018年12月四川省攀枝花市中心医院(以下简称“我院”)接诊的急性胰腺炎患者300例作为观察组,并选择我院同期体检的健康人群60名作为对照组,根据急性胰腺炎不同严重程度将观察组分为轻度组(95例)、中度组(118例)和重度组(87例)。分析血浆缺血修饰白蛋白、肿瘤坏死因子α(TNF-α)、C反应蛋白(CRP)在各组中的水平差异,采用受试者工作特征(ROC)曲线分析缺血修饰白蛋白水平对急性胰腺炎中的诊断价值。结果观察组血浆缺血修饰白蛋白、TNF-α、CRP水平高于对照组(P<0.05);轻度组血浆缺血修饰白蛋白、TNF-α、CRP水平及Ranson评分低于中度组和重度组,且中度组上述指标低于重度组(均P<0.05);血浆缺血修饰白蛋白和TNF-α、CRP、Ranson评分之间均呈正相关(r=0.464、0.565、0.407,P<0.05);血浆缺血修饰白蛋白诊断急性胰腺炎的AUC为0.956(95%CI:0.937~0.976),约登指数为0.55,最佳截断值为83.61 U/mL,灵敏度、特异性分别为82.91%、75.21%,准确性为80.72%。结论急性胰腺炎患者中血浆缺血修饰白蛋白异常上升,与TNF-α、CRP及Ranson评分之间显著相关,血浆缺血修饰白蛋白对急性胰腺炎严重程度具有诊断价值。Objective To investigate the changes and clinical significance of plasma ischemia-modified albumin in patients with acute pancreatitis.Methods A total of 300 patients with acute pancreatitis admitted to Panzhihua Central Hospital,Sichuan Province(hereinafter referred to as“our hospital”)from February 2017 to December 2018 were selected as the observation group,and 60 healthy people who underwent physical examination in our hospital during the same period were selected as the control group.According to the different severity of acute pancreatitis,the observation group was divided into the mild group(95 cases),the moderate group(118 cases)and the severe group(87 cases).Plasma ischemia-modified albumin,tumor necrosis factor-α(TNF-α),and C-reactive protein(CRP)levels in each group were analyzed.The diagnostic value of ischemia-modified albumin levels in acute pancreatitis was analyzed by receiver operating characteristic(ROC)curve.Results The levels of plasma ischemia-modified albumin,TNF-αand CRP in the observation group were higher than those in the control group(P<0.05).The levels of plasma ischemia-modified albumin,TNF-α,CRP and Ranson score in the mild group were lower than those in the moderate and severe groups,and the above indexes in the moderate group were lower than those in the severe group(all P<0.05).Plasma ischemia-modified albumin was positively correlated with TNF-α,CRP and Ranson score(r=0.464,0.565,0.407,P<0.05).The AUC of plasma ischaemic-modified albumin in the diagnosis of acute pancreatitis was 0.956(95%CI:0.937-0.976),the youden index was 0.55,the optimal cut-off value was 83.61 U/mL,the sensitivity and specificity were 82.91%and 75.21%,respectvely and the accuracy was 80.72%.Conclusion Abnormal increase of plasma ischemia-modified albumin in patients with acute pancreatitis is significantly correlated with TNF-α,CRP and Ranson score.Plasma ischemia-modified albumin has diagnostic value for the severity of acute pancreatitis.

关 键 词：急性胰腺炎 缺血修饰白蛋白 肿瘤坏死因子-α C反应蛋白 

分 类 号：R576[医药卫生—消化系统]