急性胰腺炎并发脓毒症的危险因素及T细胞免疫球蛋白黏蛋白分子3基因多态性对其的诊断价值  

Risk factors of acute pancreatitis complicated with sepsis and diagnostic value of T cell immunoglobulin mucin molecule 3 and gene polymorphism

作　　者：许凌峰[1] 李艳[1] 张丽[2] 任冬[1] 刘鑫鑫 XU Ling-feng;LI Yan;ZHANG Li;REN Dong;LIU Xin-xin(Zhoukou Vocational and Technical College,Zhoukou,Henan 466000,China;不详)

机构地区：[1]周口职业技术学院护理学院,河南周口466000 [2]周口职业技术学院护理教研室,河南周口466000 [3]河南中医药大学第三附属医院消化内镜科,河南郑州450000

出　　处：《中华医院感染学杂志》2023年第11期1670-1674,共5页Chinese Journal of Nosocomiology

基　　金：河南省医学教育研究项目(Wjlx2020370)。

摘　　要：目的探讨急性胰腺炎并发脓毒症患者T细胞免疫球蛋白黏蛋白分子3(TIM-3)、血清指标和基因多态性对其诊断价值。方法选择河南中医药大学第三附属医院外科2019年5月-2021年5月因急性胰腺炎入院治疗的患者为研究对象。按照是否并发脓毒症,1∶1纳入并发脓毒症的急性胰腺炎(并发脓毒症组)和未并发脓毒症急性胰腺炎患者(未并发脓毒症组)各72例。通过电子病历系统获取并收集两组年龄、性别、急性生理与慢性健康Ⅱ(APACHEⅡ)评分、机械通气、手术方式和感染性胰腺坏死情况。检测两组患者血清中总胆固醇、甘油三酯、白蛋白、血糖水平。采用聚合酶链式扩增反应检测TIM-3基因rs1036199位点基因多态性分布,采用酶联免疫吸附法检测血清中TIM-3水平。结果并发脓毒症组入院时APACHEⅡ评分、感染性胰腺坏死比例高于未并发脓毒症组(P<0.05);并发脓毒症组血清总胆固醇、甘油三酯、血糖水平高于未并发脓毒症组,并发脓毒症组携带TIM-3基因rs1036199位点CC基因型、C等位基因频率高于未并发脓毒症组,血清白蛋白水平低于未并发脓毒症组(P<0.05);两组肌酐、TIM-3基因rs1036199位点AC基因型比较差异无统计学意义;多因素Logistic回归分析结果显示APACHEⅡ评分、感染性胰腺坏死、总胆固醇、甘油三酯、血糖、白蛋白和TIM-3基因rs1036199位点CC基因型是急性胰腺炎患者并发脓毒症的危险因素(P<0.05);受试者工作特征(ROC)曲线分析结果显示血清TIM-3水平预测急性胰腺炎并发脓毒症曲线下面积优于总胆固醇、甘油三酯和血糖。结论TIM-3基因rs1036199位点CC基因型增加急性胰腺炎患者并发脓毒症风险,血清TIM-3水平对于预测急性胰腺炎并发脓毒症具有较高诊断价值。OBJECTIVE To investigate the diagnostic value of T cell immunoglobulin mucin 3(TIM-3),serum indicators and gene polymorphism in patients with acute pancreatitis complicated by sepsis.METHODS Patients who were admitted to the Department of Surgery of the Third Affiliated Hospital of Henan University of Chinese Medicine for acute pancreatitis from May 2019 to May 2021 were selected as the research subjects.Totally 72 patients each with acute pancreatitis complicated by sepsis(complicated sepsis group)and acute pancreatitis without sepsis(uncomplicated sepsis group)were included in 1∶1 according to whether they were complicated by sepsis or not.Age,gender,acute physiology and chronic health scoreⅡ(APACHEⅡ),mechanical ventilation,surgical methods and infectious pancreatic necrosis were obtained and collected from both groups through the electronic medical record system.The serum levels of total cholesterol,triglycerides,albumin,and blood glucose were measured in both groups.Polymerase chain amplification reaction was used to detect the distribution of TIM-3 gene rs1036199 gene polymorphism,and enzyme-linked immunosorbent assay was used to detect the serum TIM-3 level.RESULTS The APACHEⅡscore and proportion of infected pancreatic necrosis cases at admission in the complicated sepsis group were higher than those in the uncomplicated b sepsis group(P<0.05).The levels of total cholesterol,triglycerides,and blood glucose in the complicated sepsis group were higher than those of the uncomplicated sepsis group.The frequency of CC genotype and C allele at locus rs1036199 of the complicated sepsis group carrying TIM-3 gene was higher than that of the uncomplicated sepsis group,while the serum albumin level was lower than that of the uncomplicated sepsis group(P<0.05);there was no significant difference in the creatinine and AC genotype of TIM-3 gene rs1036199 site between the two groups;multivariate logistics regression analysis showed that APACHEⅡscores,infected pancreatic necrosis,total cholesterol,triglycerides,b

关 键 词：T细胞免疫球蛋白黏蛋白分子3 基因多态性 急性胰腺炎 脓毒症 预测价值 危险因素 

分 类 号：R576[医药卫生—消化系统]