重症胰腺炎患者血清载脂蛋白B/载脂蛋白A1、微管相关蛋白1-轻链3和细胞间黏附分子-1水平在预测并发感染性胰腺坏死中的价值  

Value of serum levels of apolipoprotein B/apolipoprotein A1,microtubule-associated protein 1-light chain 3 and intercellular adhesion molecule-1 in predicting concurrent infectious pancreatic necrosis in patients with severe pancreatitis

作　　者：敖雪[1] 邓超[1] 吴生赞 AO Xue;DENG Chao;WU Shengzan(Department of Critical Care Medicine,Haikou Hospital,Xiangya Medical College,Central South University,Haikou,Hainan 570208,China)

机构地区：[1]中南大学湘雅医学院附属海口医院重症医学科,海南海口570208

出　　处：《国际检验医学杂志》2023年第17期2074-2079,共6页International Journal of Laboratory Medicine

基　　金：海南省自然科学基金项目面上项目(819MS139);海南省卫生健康行业科研项目(21A200058)。

摘　　要：目的观察重症胰腺炎(SAP)患者血清载脂蛋白B与载脂蛋白A1比值(ApoB/ApoA1)、微管相关蛋白1-轻链3(MAP1-LC3)及细胞间黏附分子-1(ICAM-1)水平,并分析其与患者并发感染性胰腺坏死(IPN)的关系和预测价值。方法选取2019年1月至2022年1月于该院收治的172例SAP患者作为SAP组。收集临床资料及外周静脉血标本,检测患者血清ApoB/ApoA1、MAP1-LC3和ICAM-1水平,同期选取该院70例体检健康者作为对照组。比较SAP患者与体检健康者的血清ApoB/ApoA1、MAP1-LC3和ICAM-1水平差异;根据SAP患者后续有无并发IPN分为IPN组和非IPN组。采用单因素及多因素分析比较两组患者临床资料,分析血清ApoB/ApoA1、MAP1-LC3、ICAM-1水平及其他相关因素与SAP患者并发IPN的关系;并通过绘制受试者工作特征(ROC)曲线,分析血清ApoB/ApoA1、LC3和ICAM-1水平用于预测SAP患者并发IPN的价值。结果SAP组血清ApoB/ApoA1、MAP1-LC3、ICAM-1水平均高于对照组(均P<0.05);单因素分析显示,IPN组ApoB/ApoA1、MAP1-LC3及ICAM-1水平均高于非IPN组(均P<0.05),多因素分析显示,ApoB/ApoA1(β=2.309,P=0.027)、MAP1-LC3(β=5.447,P=0.037)及ICAM-1(β=0.039,P=0.045)水平均是SAP患者并发IPN的影响因素。血清ApoB/ApoA1、MAP1-LC3及ICAM-1水平预测SAP患者并发IPN的曲线下面积(AUC)分别为0.761(95%CI:0.683~0.840)、0.765(95%CI:0.681~0.848)、0.882(95%CI:0.829~0.935);灵敏度分别为76.1%、68.7%、71.6%,特异度分别为61.0%、89.5%、91.4%。联合预测的AUC为0.957,灵敏度为85.1%,特异度为96.2%。结论血清ApoB/ApoA1、MAP1-LC3、ICAM-1水平是SAP患者并发IPN的影响因素,并发IPN的患者ApoB/ApoA1、MAP1-LC3和ICAM-1水平更高,这些指标对于预测SAP患者并发IPN具有一定的价值。Objective To observe the levels of apolipoprotein B to apolipoprotein A1 ratio(ApoB/ApoA1),microtubule-associated protein 1-light chain 3(MAP1-LC3)and intercellular adhesion molecule-1(ICAM-1)in serum of patients with severe pancreatitis(SAP),and to analyze their relationship with infected pancreatic necrosis(IPN)and their predictive value.Methods A total of 172 patients with severe pancreatitis admitted to the hospital from January 2019 to January 2022 were included in the study.Clinical data and peripheral venous blood samples were collected to detect the levels of ApoB/ApoA1,MAP1-LC3 and ICAM-1 in the serum of patients.At the same time,serum samples from 70 healthy people in the hospital were selected as the control group.The ApoB/ApoA1 ratio,MAP1-LC3 and ICAM-1 levels were compared between SAP patients and healthy persons.The patients were divided into IPN group and non-IPN group according to whether they had concurrent IPN.Univariate and multivariate analysis were used to compare the clinical data of the two groups,and the relationship between ApoB/ApoA1 ratio,MAP1-LC3,ICAM-1 levels and other related factors and IPN in SAP patients was analyzed.The receiver operating characteristic(ROC)curve was drawn to analyze the value of ApoB/ApoA1 ratio,LC3 and ICAM-1 levels in predicting IPN in SAP patients.Results The levels of ApoB/ApoA1,MAP1-LC3 and ICAM-1 in SAP group were significantly higher than those in control group(P<0.05).Univariate analysis showed that ApoB/ApoA1 ratio,MAP1-LC3 and ICAM-1 levels in IPN group were significantly higher than those in non-IPN group(P<0.05)Multivariate analysis showed that ApoB/ApoA1(β=2.309,P=0.027),MAP1-LC3(β=5.447,P=0.037)and ICAM-1(β=0.039,P=0.045)levels were significantly correlated with IPN in SAP patients.The area under the curve(AUC)of ApoB/ApoA1,MAP1-LC3 and ICAM-1 in predicting IPN in SAP patients was 0.761(95%CI:0.683-0.840),0.765(95%CI:0.681-0.848)and 0.882(95%CI:0.829-0.935),respectively.The sensitivity was 76.1%,68.7%and 71.6%,and the specificity was 61.0%,89.5%

关 键 词：重症胰腺炎 感染性胰腺坏死 血清载脂蛋白B/载脂蛋白A1 微管相关蛋白1-轻链3 细胞间黏附分子-1水平 

分 类 号：R446.1[医药卫生—诊断学]