血清纤溶酶原激活物抑制剂-1、单核细胞趋化蛋白-1水平升高有助于诊断重症急性胰腺炎并发胰腺感染  

Increased serum PAI-1 and MCP-1 levels are helpful for diagnosis of severe acute pancreatitis complicated with pancreatic infection

作　　者：李新强 阎春英[2] 宗媛[1] 宗伟[2] 张怡[1] 李博玲[1] 牛丹[1] 荆成桥 LI Xin-qiang;YAN Chun-ying;ZONG Yuan;ZONG Wei;ZHANG Yi;LI Bo-ling;NIU Dan;JING Cheng-qiao(Department of Critical Care Medicine,Shaanxi Provincial People's Hospital,Shanxi Xi'an 710068,China;Department of Gastroenterology,Shaanxi Provincial People's Hospital,Shanxi Xi'an 710068,China)

机构地区：[1]陕西省人民医院重症医学科,陕西西安710068 [2]陕西省人民医院消化内一科,陕西西安710068

出　　处：《内科急危重症杂志》2023年第1期34-36,45,共4页Journal of Critical Care In Internal Medicine

基　　金：陕西省自然科学基础研究计划项目(No:2020JM-654)。

摘　　要：目的:探究重症急性胰腺炎(SAP)患者血清纤溶酶原激活物抑制剂-1(PAI-1)、单核细胞趋化蛋白1(MCP-1)表达水平对SAP并发胰腺感染的诊断价值。方法:选取132例SAP患者,根据发病2周后是否并发胰腺感染分为感染组(40例)和非感染组(92例)。采用酶联免疫吸附法(ELISA)检测所有患者入院次日血清中PAI-1、MCP-1水平。采用受试者工作特征曲线(ROC)分析血清PAI-1、MCP-1水平对SAP并发胰腺感染的诊断价值。采用Logistic回归分析影响SAP并发胰腺感染的危险因素。结果:与非感染组比较,感染组住院天数较长,死亡率、手术率、血清PAI-1水平及MCP-1水平较高(P均<0.05);ROC显示,血清PAI-1、MCP-1水平单独诊断SAP并发胰腺感染的曲线下面积(AUC)为0.796、0.760,二者联合诊断SAP并发胰腺感染的AUC为0.845(95%CI:0.773~0.917),敏感度、特异性分别为85.00%、76.10%。Logistic分析显示,PAI-1、MCP-1是重症胰腺炎并发胰腺感染的危险因素(P均<0.05)。结论:SAP并发胰腺感染患者血清PAI-1、MCP-1水平上升,PAI-1联合MCP-1有助于SAP并发胰腺感染早期诊断。Objective:To explore the diagnostic value of serum plasminogen activator inhibitor-1(PAI-1)and monocyte chemotactic protein-1(MCP-1)expression levels in patients with severe acute pancreatitis(SAP)complicated with pancreatic infection.Methods:A total of 132 patients with SAP were divided into infected group(40 cases)and uninfected group(92 cases)according to whether they were complicated with pancreatic infection within 2 weeks.Enzyme-linked immunosorbent assay(ELISA)was used to detect the levels of PAI-1 and MCP-1 in serum on the day after admission.The ROC method was used to analyze the diagnostic value of serum PAI-1 and MCP-1 levels in SAP complicated with pancreatic infection.Logistic regression was used to analyze the risk factors affecting SAP complicated with pancreatic infection.Results:As compared with the uninfected group,the hospital stay(days),mortality,operation rate,the serum PAI-1 and MCP-1 levels in the infected group were higher(P<0.05);ROC results showed that the area under the curve(AUC)of serum PAI-1 and MCP-1 levels in the diagnosis of SAP complicated with pancreatic infection was 0.796 and 0.760 respectively,the AUC of the two combined diagnosis of SAP complicated with pancreatic infection was 0.845(95%CI:0.773-0.917),and the sensitivity and specificity were 85.00%and 76.10%,respectively.Logistic analysis showed that PAI-1 and MCP-1 were risk factors for severe pancreatitis complicated with pancreatic infection(P<0.05).Conclusion:The levels of serum PAI-1 and MCP-1 in patients with SAP complicated with pancreatic infection increase.The combination of PAI-1 and MCP-1 is helpful for the early diagnosis of SAP complicated with pancreatic infection.

关 键 词：重症急性胰腺炎 纤溶酶原激活物抑制剂-1 单核细胞趋化蛋白-1 胰腺感染 诊断价值 

分 类 号：R576[医药卫生—消化系统]