血清AGP2、LBP及PCT对急性胰腺炎患者严重程度的预测价值  

The predictive value of serum AGP2,LBP and PCT in the severity of acute pancreatitis

作　　者：王宇鹏 宋凯 孙远松 姜大同[1] 李贺[1] WANG Yu-peng;SONG Kai;SUNYuan-song(The Second Hospital of Anhui Medical University,Hefei 230000,China)

机构地区：[1]安徽医科大学第二附属医院急诊外科,合肥230000

出　　处：《肝胆外科杂志》2023年第5期349-355,共7页Journal of Hepatobiliary Surgery

基　　金：安徽省医学会急诊医学分会急诊临床研究项目(Ky2021018)。

摘　　要：目的本研究探讨急性胰腺炎(acute pancreatitis,AP)患者人院后24小时内血清中α-1-酸糖蛋白2(AGP2)、脂多糖结合蛋白(LBP)及降钙素原(PCT)对AP患者病情的早期评估价值。方法收集2021年6月至2022年12月安徽医科大学第二附属医院急诊外科收治的急性胰腺炎患者临床资料,并在入院24小时内收集患者血清。根据2012年亚特兰大国际会议修订后的亚特兰大分类,将患者分为非重症急性胰腺炎(non-severe acute pancreatitis,Non-SAP)组(n=156例)和重症急性胰腺炎(severe acute pancreatitis,SAP)组(n=71例)两组,比较两组间AGP2、LBP、PCT及综合评分指标的差异,利用Spearman相关分析分析其与AP病情严重程度的相关性。采用Logistic回归分析SAP的预测因素,绘制受试者工作特征曲线并分析曲线下面积(AUC),评价上述指标的预测效能。结果SAP组与Non-SAP组比较,Ranson评分、SOFA评分、CTSI评分、AGP2、LBP、PCT均差异有统计学意义(P<0.05),而性别、年龄、体重指数、收缩压、舒张压两组之间比较差异无统计学意义(P>0.05)。Spearman相关分析显示AGP2、LBP及PCT水平与AP病情严重程度呈正相关(P<0.05)。Logistic回归分析提示AGP2、LBP及PCT为AP患者发生SAP的独立危险因素(P<0.05)。ROC曲线示Ranson评分.SOFA评分CTSI评分、AGP2、LBP以及PCT为AP严重程度的重要预测因素(均AUC>0.7)。而AGP2、LBP及PCT三项指标的联合检测(AUC=0.895)对SAP的预测性能优于AGP2(AUC=0.844)、LBP(AUC=0.728)及PCT(AUC=0.799)指标的单独使用。结论AP患者人院24h内血清AGP2LBP及PCT水平对早期预测AP病情的严重程度有一定的临床意义,且三者联合时预测价值更高。Objective To invetigate the early evaluation value of alpha-1-acid glycoprolein 2(AGP2),lipopolysaccharide-binding protein(LBP)and procalcitonin(PCT)in patients with acute pancreatitis(AP)within 24 hours after admission.Methods The clinical data of acute pancreatitis patients admitted to the Emergency Surgery Department of the Second Affiliated Hospital of Anhui Medical University were collected between June 202 I and December 2022 and the serum of the patients was collected within 24 hours of admission.According to the revised Atlanta classification from the 2012 Atlanta Intermnational Conference,the patients were divided into non-severe acute pancreatitis(Non-SAP)group(n=156)and severe acute pancreatitis(SAP)group(n=71).The differences in AGP2,LBP,PCT and integrated scores between the two groups were compared,and the correlation between them and AP severity was analyzed using Spearman correlation analysis.Logistic regression was used to analyze the predictive factors of SAP,and the receiver operating characteristic curve was drawn and the area under the curve(AUC)was analyzed to evaluate the predictive efficacy of the a bove indicators.Results Ranson score,SOFA score,CTSI score,AGP2,LBP and PCT were significantly different between SAP group and Non-SAP group(P<0.05),while gender,age,body mass index,systolie blood pressure and diastolice blood pressure were not significantly different between the two groups(P>0.05).Spearman correlation analysis showed that AGP2,LBP and PCT levels were positively correlated with the severity of AP(P<0.05).Logistic regression analysis showed that AGP2,LBP and PCT were inde-pendent risk factors for SAP in AP patients(P<0.05).ROC curve showed that Ranson score,SOFA score,CTSI score,AGP2,LBP and PCT were important predictors of AP severity(all AUC>0.7).The combined detection of AGP2,LBP and PCT(AUC=0.895)was better than the single use of AGP2(AUC=0.844),LBP(AUC=0.728)and PCT(AUC=0.799)in predicting SAP.Conclu-sion The serum levels of AGP2,LBP and PCT in patients with AP within 24 hou

关 键 词：急性胰腺炎 重症急性胰腺炎 α-1-酸糖蛋白2 脂多糖结合蛋白 降钙素原 预测 

分 类 号：R659[医药卫生—外科学]