sICAM-1和sFlt-1联合检测对急性胰腺炎病情评估和预后判断的临床价值研究  

The Clinical Value of Combined Detection of sICAM-1 and sFLT-1 in the Assessment and Prognosis of Acute Pancreatitis

作　　者：毛雨彤 吴兆华 范辉[2] MAO Yutong;WU Zhaohua;FAN Hui(Emergency Department of Hai’an Hospital Affiliated to Nantong University,Hai’an 226600,China;Department of Gastroenterology,Nantong Second People’s Hospital,Nantong 226600,China)

机构地区：[1]南通大学附属海安医院急诊科,江苏海安226600 [2]南通市第二人民医院消化内科,江苏南通226001

出　　处：《标记免疫分析与临床》2021年第8期1287-1291,共5页Labeled Immunoassays and Clinical Medicine

基　　金：南通市2018年度市级科技计划项目(编号:MSZ18203)。

摘　　要：目的探讨血清可溶性细胞间粘附分子1(sICAM-1)和可溶性fms样酪氨酸激酶-1(sFlt-1)联合检测在急性胰腺炎(acute pancreatitis,AP)患者病情和预后判断的临床价值。方法将南通大学附属海安医院急诊科2019年1月至2020年9月收治的72例AP患者列入观察组,按照急性生理与慢性病评分系统Ⅱ(APACHEⅡ)评分分成轻度组、中度组和重度组3个亚组,按照疾病转归,分为生存组和死亡组2个亚组;选择同期非肝胆胰疾病的急腹症35例列入对照组。检测血清sICAM-1和sFlt-1水平,并进行Pearson分析。结果观察组入院时血清sICAM-1、sFlt-1水平和APACHEⅡ评分高于对照组(P<0.001),血清sICAM-1、sFlt-1水平呈上升趋势,入院第3d时达到峰值,第7d时逐渐回落(P<0.001);病情重度组血清sICAM-1、sFlt-1水平高于中度组和轻度组,呈逐渐升高趋势(P<0.001);死亡组血清sICAM-1和sFlt-1水平高于生存组(P<0.001)。经过Pearson相关分析,血清sICAM-1和sFlt-1水平联合检测的AUC、约登指数、灵敏度和特异性等效能指标高于单个指标检测(P<0.05)。结论血清sICAM-1和sFlt-1水平是反映AP患者的病情程度和预后评估的可靠指标,联合检测的临床价值更显著。Objective To investigate the clinical value of serum soluble intercellular adhesion molecule 1(sICAM-1)and soluble FMS-like tyrosine kinase-1(sFLT-1)in the diagnosis and prognosis of acute pancreatitis(AP).Methods 72 AP patients in the observation group were enrolled in the Emergency Department of Hai’an affiliated Hospital of Nantong University from January,2019 to September,2020.According to the acute physiology and chronicⅡscoring system(APACHEⅡ)scores,these patients were divided into the mild,moderate group and severe group.According to the disease outcomes,patients were divided into the survival group and death group.Thirty-five patients with acute abdomen without hepatobiliary and pancreatic diseases were included in the control group.Serum levels of sICAM-1 and sFLT-1 were detected and Pearson analysis was performed.Results In the observation group on admission,serum levels of sICAM 1,sFlt-1 and APACHEⅡscore were higher than those of the control group(P<0.001).Serum sFlt-1 and sICAM-1 levels showed an increase trend and reach the peak at the hospital 3rd d,but dropped gradually at 7th d(P<0.001).Serum levels of sICAM-1 and sFLT-1 in the severe group were higher than those of the moderate group and mild group,showing a gradually increasing trend(P<0.001).Serum levels of sICAM-1 and sFLT-1 in the death group were higher than those of the survival group(P<0.001).Pearson correlation analysis showed that the AUC,Youden index,sensitivity and specificity of serum sICAM-1 and sFLT-1 combined detection were all higher than those of single detection(P<0.05).Conclusion Serum sICAM-1 and sFLT-1 levels are reliable indicators to reflect the severity and prognosis of AP patients,and the clinical value of combined detection is more significant.

关 键 词：急性胰腺炎 SICAM-1 SFLT-1 病情程度 预后评估 价值 

分 类 号：R576[医药卫生—消化系统]