血清可溶性神经调节蛋白-1、G蛋白偶联雌激素受体-1在急性胰腺炎患者病情及预后评估中临床价值研究  

The clinical value of serum soluble neuregulin-1 and G protein coupled estrogen receptor-1 in the assessment of pathogenetic condition and prognosis in patients with acute pancreatitis

作　　者：朱琳[1] 李佳 贾晓雯 张红霞[1] ZHU Lin;LI Jia;JIA Xiao-wen;ZHANG Hong-xia(General Practice,Handan First Hospital,Handan 056002,China)

机构地区：[1]邯郸市第一医院全科医疗,河北邯郸056002

出　　处：《创伤与急危重病医学》2023年第2期125-129,共5页Trauma and Critical Care Medicine

基　　金：邯郸市科学技术厅项目(1423108063-5)。

摘　　要：目的探讨血清可溶性神经调节蛋白-1(sNRG-1)、G蛋白偶联雌激素受体-1(GPER-1)在急性胰腺炎(AP)患者病情及预后评估中的临床价值。方法选取自2019年6月至2022年6月邯郸市第一医院收治的106例AP患者为研究对象,根据AP病情严重程度分为轻症组(n=49)、中重症组(n=36)及重症组(n=21);根据预后生存情况分为存活组(n=83)与死亡组(n=23)。采用酶联免疫吸附法检测血清sNRG-1、GPER-1水平。采用受试者工作特性(ROC)曲线评估血清sNRG-1、GPER-1及两者联合检测对AP患者预后的评估价值。采用多因素Logistic回归分析探讨AP患者预后影响因素。结果中重症组、重症组患者血清sNRG-1水平低于轻症组,且重症组低于中重症组;中重症组、重症组患者血清GPER-1水平高于轻症组,且重症组高于中重症组,差异均有统计学意义(P<0.05)。存活组与死亡组病情严重程度、入院急性生理与慢性健康评分(APACHEⅡ)、白细胞计数、C反应蛋白、血肌酐、乳酸脱氢酶、血淀粉酶、血脂肪酶、sNRG-1、GPER-1比较,差异有统计学意义(P<0.05)。APACHEⅡ评分≥12分、sNRG-1≤17.74 pg/ml、GPER-1≥4.82 pg/ml是影响AP患者预后的独立危险因素(P<0.05)。血清sNRG-1、GPER-1预测AP患者预后的ROC曲线下面积分别为0.846、0.753。两者联合预测AP患者预后的ROC曲线下面积为0.917,特异度为86.75%,灵敏度为86.96%。结论血清sNRG-1低表达、GPER-1高表达与AP患者的病情严重程度及预后有关,有望作为评估AP患者预后的生物学指标。Objective To explore the clinical value of serum soluble neuregulin-1(sNRG-1)and G protein coupled estrogen receptor-1(GPER-1)in the assessment of pathogenetic condition and prognosis in patients with acute pancreatitis(AP).Methods A total of 106 AP patients admitted to Handan First Hospital from June 2019 to June 2022 were selected and divided into mild group(n=49),moderate and severe group(n=36)and severe group(n=21)according to the severity of AP.According to the prognosis,the patients were divided into survival group(n=83)and death group(n=23).Serum sNRG-1 and GPER-1 levels were detected by enzyme-linked immunosorbent assay.Receiver operating characteristic(ROC)curve was used to evaluate the prognostic value of serum sNRG-1,GPER-1 and their combination in patients with AP.Multivariate Logistic regression analysis was used to explore the prognostic factors of AP patients.Results The serum sNRG-1 level of patients in the moderate and severe groups and severe group was significantly lower than that of patients in the mild group,and the severe group was significantly lower than that in the moderate and severe group(P<0.05).The serum GPER-1 level of patients in the moderate and severe groups and severe group was significantly higher than that of patients in the mild group,and the severe group was significantly higher than that in the moderate and severe group(P<0.05).There were significant differences in the severity of disease,acute physiology and chronic health evaluationⅡ(APACHEⅡ)score,white blood cell count,C-reactive protein,serum creatinine,lactate dehydrogenase,serum amylase,serum lipase,sNRG-1 and GPER-1 between the survival group and the death group(P<0.05).APACHEⅡscore≥12 scores,sNRG-1≤17.74 pg/ml,GPER-1≥4.82 pg/ml were independent risk factors for the prognosis of AP patients(P<0.05).The areas under the ROC curve of serum sNRG-1 and GPER-1 to predict the prognosis of AP patients were 0.846 and 0.753,respectively.The area under the ROC curve of serum sNRG-1 and GPER-1 combination to predict t

关 键 词：可溶性神经调节蛋白-1 G蛋白偶联雌激素受体-1 急性胰腺炎 预后 

分 类 号：R576[医药卫生—消化系统]