急性胰腺炎患者血清中CRP/ALB、Ghrelin、IMA水平变化与病情进展的关系  

Relationship between changes in serum levels of CRP/ALB,Ghrelin and IMA and disease progression in patients with acute pancreatitis

作　　者：田丰[1] 黄丽敏[1] 周正端[1] TIAN Feng;HUANG Limin;ZHOU Zhengduan(Department of Gastroenterology,Fourth People's Hospital of Zigong,Zigong,Sichuan 643000,China)

机构地区：[1]自贡市第四人民医院消化内科,四川自贡643000

出　　处：《国际检验医学杂志》2023年第8期983-987,共5页International Journal of Laboratory Medicine

基　　金：自贡市卫生计生系统科研课题(2017wZCS01)。

摘　　要：目的探讨血清C反应蛋白(CRP)/清蛋白(ALB)、人生长激素释放肽(Ghrelin)、缺血修饰清蛋白(IMA)水平变化与急性胰腺炎(AP)患者病情进展的关系及临床意义。方法选取2019年5月至2022年5月该院106例AP患者作为观察组,其中轻症56例、重症50例;另选取同期该院体检健康者60例作为对照组。比较两组及观察组组内不同病情程度患者血清CRP/ALB、Ghrelin、IMA水平,分析血清CRP/ALB、Ghrelin、IMA水平与病情程度的相关性,评估血清CRP/ALB、Ghrelin、IMA水平对重症AP的诊断价值,并分析血清CRP/ALB、Ghrelin、IMA水平与AP患者死亡风险的关系。结果观察组血清CRP/ALB、Ghrelin、IMA水平均高于对照组(P<0.05);AP患者入院72 h内血清CRP/ALB、Ghrelin、IMA水平均先升高后下降,且重症患者入院时,入院24、48及72 h血清CRP/ALB、Ghrelin、IMA水平均高于轻症患者(P<0.05);AP患者入院72 h时血清CRP/ALB、Ghrelin、IMA水平与病情严重程度[急性胰腺炎严重程度床边指数(BISAP评分、Ranson评分]呈正相关(P<0.05);以重症患者为阳性,轻症患者为阴性,入院48 h血清CRP/ALB、Ghrelin、IMA水平诊断重症AP患者的曲线下面积(AUC)分别为0.783、0.764、0.821,各指标联合诊断的AUC为0.924,大于各指标单独诊断(P<0.05);血清CRP/ALB、Ghrelin、IMA高水平组病死风险分别是低水平组的2.927、2.464、3.157倍。结论血清CRP/ALB、Ghrelin、IMA与AP病情密切相关,可为临床早期病情评估及预测预后结局提供参考依据,以制订相应治疗方案,降低病死风险。Objective To investigate the relationship between the changes of serum C-reactive protein(CRP)/albumin(ALB),human growth hormone releasing peptide(Ghrelin)and ischemia-modified albumin(IMA)levels and the disease progression in patients with acute pancreatitis(AP)and its clinical significance.Methods A total of 106 AP patients in the hospital from May 2019 to May 2022 were selected as the observation group,including 56 mild cases and 50 severe cases.Another 60 healthy subjects in the hospital during the same period were selected as the control group.The serum CRP/ALB,Ghrelin and IMA levels of patients in the two groups and patients in the observation group with different disease severity were compared,and the correlation between the serum CRP/ALB,Ghrelin and IMA levels and the disease severity was analyzed,and the diagnosis value of serum CRP/ALB,Ghrelin and IMA levels on the severity of the disease was evaluated.The relationship between serum CRP/ALB,Ghrelin,IMA levels and mortality risk in AP patients was analyzed.Results The levels of serum CRP/ALB,Ghrelin and IMA in the observation group were higher than those in the control group(P<0.05).The levels of serum CRP/ALB,Ghrelin and IMA in AP patients increased first and then decreased within 72 hours of admission.Serum CRP/ALB,Ghrelin and IMA levels at admission,at 24,48 and 72 hours after admission in severe patients were higher than those in mild patients(P<0.05).The serum CRP/ALB,Ghrelin,and IMA levels of AP patients were positively correlated with the severity of the disease(BISAP score,Ranson score)at 72 hours after admission(P<0.05).The values of area under the curve(AUC)of serum CRP/ALB,Ghrelin and IMA levels in the diagnosis of severe AP were 0.783,0.764,and 0.821,respectively.The AUC of the combined detection was 0.924,which was larger than the AUC of each index alone(P<0.05).The risk of mortality in the high level group of serum CRP/ALB,Ghrelin,and IMA was 2.927,2.464,3.157 times higher than that in the low level group(P<0.05).Conclusion Serum CRP/ALB,Gh

关 键 词：急性胰腺炎 C反应蛋白 清蛋白 人生长激素释放肽 缺血修饰清蛋白 

分 类 号：R446.1[医药卫生—诊断学]