血清可溶性B7-H4联合BISAP评分评估急性胰腺炎患者病情及疾病转归的临床价值  

Clinical value of serum soluble B7-H4 combined with BISAP score in evaluating condition and outcome of acute pancreatitis

作　　者：郭宝中[1] 李璐璐[1] 冯常炜 GUO Bao-zhong;LI Lu-lu;FENG Chang-wei(Department of Gastroenterology,Affiliated Hospital of Huanghe University of Science and Technology,Zhengzhou 450000,China)

机构地区：[1]黄河科技学院附属医院消化内科,郑州450000

出　　处：《医药论坛杂志》2023年第12期85-88,93,共5页Journal of Medical Forum

摘　　要：目的探讨血清可溶性协同刺激分子B7家族4(soluble costimulatory molecules B7 Homolog 2,B7-H4)联合急性胰腺炎严重度床旁指数(bedside index for severity in acute pancreatitis,BISAP)评分评估急性胰腺炎(acute pancreatitis,AP)患者病情及疾病转归的临床价值。方法选取2019年10月至2022年7月黄河科技学院附属医院收治的AP患者228例,根据病情严重程度,分为轻症急性胰腺炎(mild acute pancreatitis,MAP)组(117例)与重症急性胰腺炎(severe acute pancreatitis,SAP)组(111例),所有患者入院24h采集静脉血,检测一般临床指标及B7-H4水平,并进行BISAP测评,分析各指标的相关性,采用ROC曲线分析B7-H4、BISAP评分单独及联合应用预测SAP及患者死亡的效能。结果SAP组总胆固醇(5.24±0.74)mmol/L、甘油三酯(5.61±0.56)mmol/L、低密度脂蛋白胆固醇(2.78±0.89)mmol/L、白细胞计数(14.95±2.22)×10^(9)/L、血清淀粉酶(566.93±86.36)U/L、血清脂肪酶(687.18±104.77)U/L、BISAP评分(1.94±0.89)分高于MAP组[(4.77±0.65)mmol/L、(4.49±0.63)mmol/L、(2.31±0.45)mmol/L、(11.73±2.51)×10^(9)/L、(471.20±67.29)U/L、(504.68±98.64)U/L、(1.33±0.78)分)],高密度脂蛋白胆固醇(0.56±0.35)mmol/L低于MAP组(0.84±0.24)mmol/L(P<0.05);相关分析显示,白细胞计数、血清淀粉酶、脂肪酶、B7-H4、BISAP评分两两之间均呈正相关(r=0.426、0.514、0.742、0.535、0.673、0.757、0.556、0.664、0.673、0.578,P<0.05);ROC分析显示,B7-H4联合BISAP评分预测SAP、患者死亡的AUC值(0.936、0.857)、敏感性(0.894、0.866)、特异性(0.827、0.819)均高于单独应用B7-H4或BISAP评分(P<0.05)。结论B7-H4联合BISAP评分在评估AP患者病情严重程度及预后的效能优于单独采用B7-H4或BISAP评分,具有较佳的临床应用价值。Objective To investigate the clinical value of serum soluble costimulatory molecule B7-H4(B7-H4) combined with BISAP score in evaluating the condition and outcome of acute pancreatitis.Methods A total of 228 AP patients admitted from October 2019 to July 2022 were selected and divided into MAP group(117 cases) and SAP group(111 cases) according to the severity of the disease.Venous blood was collected from all patients 24 hours after admission to detect general clinical indicators and B7-H4 levels,and BISAP was evaluated to analyze the correlation of each indicator.ROC curve was used to analyze the efficacy of B7-H4 and BISAP score alone and in combination in predicting SAP and death.Results In SAP group,TC was(5.24±0.74 mmol/L),TG was(5.61±0.56),mmol/L LDL-C was(2.78±0.89) mmol/L,white blood cell count was(14.95±2.22)×10^(9)/L,serum amylase was(566.93±86.36) U/L),serum lipase(687.18±104.77)U/L,BISAP score(1.94±0.89) were higher than those of MAP group(4.77±0.65) mmol/L,4.49±0.63) mmol/L,(2.31±0.45) mmol/L,(11.73±2.51)×10^(9)/L,(471.20±67.29) U/L,(504.68±98.64) U/L,(1.33±0.78),HDL-c(0.56±0.35) mmol/L was lower than that in MAP group(0.84±0.24) mmol/L(P<0.05).Pearson correlation analysis showed that white blood cell count,serum amylase,lipase,B7-H4 and BISAP score were positively correlated(r=0.426,0.514,0.742,0.535,0.673,0.757,0.556,0.664,0.673,0.578,P<0.05).ROC analysis showed that the AUC value(0.936,0.857),sensitivity(0.894,0.866) and specificity(0.827,0.819) of B7-H4 combined with BISAP score in predicting SAP and death of patients were higher than those of B7-H4 or BISAP score alone(P<0.05).Conclusion B7-h4 combined with BISAP score has better efficacy in evaluating the severity and prognosis of AP patients than B7-H4 or BISAP score alone,which has better clinical application value.

关 键 词：B7-H4 BISAP评分 急性胰腺炎 预后 ROC分析 

分 类 号：R657.51[医药卫生—外科学]