MMP-9、PBEF及炎性因子预测重症急性胰腺炎肺损伤预后  

MMP⁃9,PBEF and Inflammatory Factors Predict the Prognosis of Severe Acute Pancre⁃atitis⁃related Lung injury

作　　者：朱丽娟 薛乾隆[1] 林雪容 韩树池[2] ZHU Lijuan;XUE Qianlong;LIN Xuerong;HAN Shuchi(Department of Emergency ICU,the First Affiliated Hospital of Hebei North University,Zhangjiakou,He-bei,China,075000;Department of Emergency,the First Affiliated Hospital of Hebei North University,Zhangjiakou,Hebei,China,075000)

机构地区：[1]河北北方学院附属第一医院急诊ICU,河北张家口075000 [2]河北北方学院附属第一医院急诊科,河北张家口075000

出　　处：《分子诊断与治疗杂志》2021年第7期1142-1145,共4页Journal of Molecular Diagnostics and Therapy

基　　金：河北省医学科学研究课题计划资助项目(20170815)。

摘　　要：目的探讨重症急性胰腺炎相关性肺损伤患者基质金属蛋白酶9(MMP-9)、前B细胞克隆增强因子(PBEF)及炎性因子白介素-8(IL-8)、肿瘤坏死因子-α(TNF-α)的变化及对预后的预测价值。方法选取2012年12月至2018年12月本院收治的88例重症胰腺炎患者为研究对象,其中合并急性肺损伤51例(观察组),未合并急性肺损伤37例(对照组)。比较2组MMP-9、PBEF、IL-8、TNF-α水平;分析影响重症急性胰腺炎相关性肺损伤患者预后不良的相关危险因素;通过ROC曲线计算AUC,分析IL-8、TNF-α、MMP-9、PBEF水平对重症急性胰腺炎相关性肺损伤患者预后不良的预测价值。结果观察组IL-8、TNF-α、MMP-9、PBEF水平均显著高于对照组,差异有统计学意义(P<0.05)。IL-8(异常增高)、TNF-α(异常增高)、MMP-9(异常增高)、PBEF(异常增高)的重症急性胰腺炎相关性肺损伤患者死亡率明显高于正常表达的患者,差异有统计学意义(P<0.05)。合并脏器衰竭、合并其他并发症IL-8(异常增高)、TNF-α(异常增高)、MMP-9(异常增高)、PBEF(异常增高)是影响重症急性胰腺炎相关性肺损伤患者预后死亡的相关危险因素(P<0.05)。IL-8、TNF-α、MMP-9、PBEF及四者联合检测AUC分别为:0.771、0.807、0.771、0.921,各指标AUC以联合检测最大。结论临床工作者可通过加强联合IL-8、TNF-α、MMP-9、PBEF检测,以评估重症急性胰腺炎相关性肺损伤患者预后。Objective To explore the changes of matrix metalloprotein⁃9(MMP⁃9),pre⁃B⁃cell colony⁃enhancing factor(PBEF)and inflammatory factors Interleukin⁃8(IL⁃8)and Tumor necrosis factor⁃α(TNF⁃α)in patients with severe acute pancreatitis⁃related lung injury and its predictive value for prognosis.Methods A total of 88 patients with severe pancreatitis admitted to this hospital from December 2012 to De⁃cember 2018 were selected as the research subjects,including 51 patients with acute lung injury(as the obser⁃vation group)and 37 patients without acute lung injury(as the control group).The levels of MMP⁃9,PBEF,IL⁃8 and TNF⁃αin the two groups were compared.The related risk factors that affect the poor prognosis of patients with severe acute pancreatitis⁃related lung injury were analyzed.AUC was calculated by the ROC curve,and the predictive value of IL⁃8,TNF⁃α,MMP⁃9,PBEF levels for the poor prognosis of patients with severe acute pancreatitis⁃related lung injury was analyzed.Results The levels of IL⁃8,TNF⁃α,MMP⁃9 and PBEF in the observation group were significantly higher than those in the control group,and the difference was statisti⁃ cally significant(P<0.05). The mortality rate of patients with severe acute pancreatitis⁃related lung injury and IL⁃8(abnormal increase),TNF⁃α(abnormal increase),MMP⁃9(abnormal increase),and PBEF(abnormal in⁃ crease)was significantly higher than that of patients with normal expression,and the difference was statistically significant(P<0.05). Complicated with organ failure,combined with other complications IL ⁃ 8(abnormal in⁃ crease),TNF⁃α(abnormal increase),MMP⁃9(abnormal increase),PBEF(abnormal increase)are affecting the prognosis of patients with severe acute pancreatitis ⁃ related lung injury Related risk factors for death(P< 0.05). The AUC of IL⁃8,TNF⁃α,MMP⁃9,PBEF and the combined detection of the four were:0.771,0.807, 0.771,0.921,respectively,and the maximum AUC of combined detection was the largest. Conclusi

关 键 词：重症急性胰腺炎 肺损伤 MMP-9 PBEF 炎性因子 

分 类 号：R576[医药卫生—消化系统]