血清ChE水平与重症胰腺炎患者应激性高血糖的相关性及对预后的影响  

Correlation between serum ChE level and stress hyperglycemia in patients with severe acute pancreatitis and its influence on prognosis

作　　者：任平香[1] 于大勇[1] 王冬梅[1] 卢新[1] 何立芳 REN Pingxiang;YU Dayong;WANG Dongmei;LU Xin;HE Lifang(Department of Endocrinology,People′s Hospital of Fengrun District,Tangshan,Hebei 064000,China;Department of Endocrinology,Tangshan People′s Hospital,Tangshan,Hebei 063001,China)

机构地区：[1]唐山市丰润区人民医院内分泌科,河北唐山064000 [2]唐山市人民医院内分泌科,河北唐山063001

出　　处：《国际检验医学杂志》2021年第14期1748-1751,1756,共5页International Journal of Laboratory Medicine

基　　金：河北省科学技术厅基金项目(20151437);唐山市科技局基金项目(20200400)。

摘　　要：目的探讨血清胆碱酯酶(ChE)水平与重症胰腺炎患者应激性高血糖的相关性及对预后的影响。方法选择唐山市丰润区人民医院(下称本院)重症胰腺炎患者192例为病例组,分为胰腺炎组100例,胰腺炎高血糖组92例,选择同期本院门诊体检健康者87例为对照组,测定各组三酰甘油(TG)、低密度脂蛋白胆固醇(LDL-C)、ChE、空腹血糖、尿素氮(BUN)、肌酐、血细胞比容(HCT)、白细胞(WBC)、脂肪酶(LPS)、C-反应蛋白(CRP)、白细胞介素-2(IL-2)、IL-6、肿瘤坏死因子(TNF)水平及急性生理与慢性健康(APACHEⅡ)评分。结果病例组ChE水平高于对照组,差异有统计学意义(P<0.05);胰腺炎高血糖组ChE、空腹血糖、BUN、肌酐、HCT、APACHEⅡ评分水平高于胰腺炎组,差异有统计学意义(P<0.05);胰腺炎高血糖组WBC、LPS、CRP、IL-2、IL-6、TNF水平高于胰腺炎组,差异有统计学意义(P<0.05);ChE与WBC、LPS、CRP、IL-2、IL-6、TNF、空腹血糖、BUN、肌酐、HCT、APACHEⅡ评分呈正相关关系(P<0.05);高水平的ChE、APACHEⅡ评分、WBC均为重症胰腺炎患者应激性高血糖发生的独立危险因素(P<0.05);ChE高表达组不良预后事件(主要为肺肾损害、循环衰竭、水电解质和酸碱平衡紊乱、心肌损害、消化道出血等)发生率高于ChE低表达组,差异有统计学意义(P<0.05)。结论重症胰腺炎患者应激性高血糖血清ChE水平升高,高水平的ChE为重症胰腺炎患者应激性高血糖发生的独立危险因素;高水平的ChE与重症胰腺炎患者应激性高血糖不良预后相关。Objective To investigate the correlation between serum cholinesterase(ChE)level and stress hyperglycemia in patients with severe acute pancreatitis and its influence on prognosis.Methods One hundred and ninety-two patients with severe pancreatitis were divided into pancreatitis group(n=100)and pancreatitis hyperglycemia group(n=92).Eighty seven healthy outpatients in tangshan fengrun district people′s hospital hospital were selected as control group.Triglyceride(TG),low density lipoprotein cholesterol(LDL-C),ChE,fasting blood glucose,urea nitrogen(BUN),creatinine,hematocrit(HCT),white blood cell(WBC),lipase(LPS),C-reactive protein(CRP),interleukin-2(IL-2),IL-6,tumor necrosis factor(TNF)levels and acute physiology and chronic health(APACHEⅡ)score were measured.Results The level of ChE in the case group was higher than that in the control group,and the difference was statistically significant(P<0.05);the score levels of ChE,fasting blood glucose,bun,creatinine,HCT and APACHEⅡin the hyperglycemia group were higher than those in the pancreatitis group,and the differences were statistically significant(P<0.05);the levels of WBC,LPS,CRP,IL-2,IL-6 and TNF in the hyperglycemia group were higher than those in the pancreatitis group,and the differences were statistically significant(P<0.05);ChE was positively correlated with WBC,LPS,CRP,IL-2,IL-6,TNF,FBG,bun,creatinine,HCT and APACHEⅡscores,and the differences were statistically significant(P<0.05);High level of ChE,APACHEⅡscore and WBC were independent risk factors for stress hyperglycemia in patients with severe pancreatitis,the differences were statistically significant(P<0.05);the incidence of adverse prognostic events(mainly lung and kidney damage,circulatory failure,water electrolyte and acid-base balance disorder,myocardial damage,gastrointestinal bleeding,etc.)in the high expression group of ChE was higher than that in the low expression group of ChE,the difference was statistically significant(P<0.05).Conclusion The serum ChE level of severe pancreatitis

关 键 词：胆碱酯酶 重症胰腺炎 应激性高血糖 预后 

分 类 号：R576[医药卫生—消化系统]