急性胰腺炎继发器官功能衰竭患者凝血功能及外周血TIM-3 TAT ACE2水平变化分析  

Analysis of Coagulation Function and Peripheral Blood TIM-3 TAT ACE2 Levels in Patients with Acute Pancreatitis and Secondary Organ Failure

作　　者：李军 魏国峰[1] 蔡兆辉[1] 李海山[1] LI Jun;WEI Guofeng;CAI Zhaohui(Hefei Second People's Hospital,Anhui Hefei 230011,China)

机构地区：[1]安徽省合肥市第二人民医院急诊科,安徽合肥230011

出　　处：《河北医学》2024年第3期436-441,共6页Hebei Medicine

基　　金：2019年安徽省重点研究与开发计划项目,(编号:201904a07020072)。

摘　　要：目的:本研究旨在探究急性胰腺炎继发器官功能衰竭患者凝血功能的变化,并分析外周血中T细胞免疫球蛋白黏蛋白分子3(TIM-3)、凝血酶-抗凝血酶复合物(TAT)以及血管紧张素转换酶2(ACE2)水平的变化。方法:本研究开展时间为2020年8月至2022年8月,研究对象为在我院接受诊疗的118例急性胰腺炎患者,根据亚特兰大分级标准对患者的病情严重程度进行评价,并据此进行分组:轻度组(n=72)和重度组(n=46),对两组患者间的凝血功能指标及外周血TIM-3、TAT、ACE2水平进行比较,并探究患者继发器官功能衰竭与各指标的联系。结果:重度组患者的凝血功能指标(PT、INR、APTT和FIB)和外周血中TIM-3和TAT水平均高于轻度组,ACE2水平低于轻度组(P<0.05);继发组患者的凝血功能指标(PT、INR、APTT和FIB)和外周血中TIM-3和TAT水平均高于未继发组,ACE2水平低于未继发组(P<0.05);经多因素分析可知,PT、INR、APTT、FIB、TIM-3、TAT、ACE2均会影响患者继发器官功能衰竭,其预测患者继发器官功能衰竭的AUC值分别为0.846、0.926、0.819、0.862、0.751、0.847、0.858。结论:在急性胰腺炎患者中,凝血功能异常以及外周血中TIM-3、TAT的升高和ACE2的降低与疾病的严重程度密切相关,对急性胰腺炎继发器官功能衰竭风险有潜在的预测价值。Objective:This study aimed to investigate alterations in coagulation function among patients with acute pancreatitis(AP)and secondary organ failure(OF)and analyze variations in peripheral blood levels of T cell immunoglobulin and mucin domain 3(TIM-3),thrombin-antithrombin complex(TAT),and angiotensin-converting enzyme 2(ACE2).Methods:Conducted between August 2020 and August 2022,the study involved 118 patients with AP admitted for treatment.Patient severity was assessed using the Atlanta Classification and categorized into mild(n=72)and severe(n=46)groups.Coagulation function indices and peripheral blood TIM-3,TAT,ACE2 levels were compared between the groups,investigating the relationship between secondary organ failure and these parameters.Results:Patients in the severe group exhibited significantly elevated coagulation function indices(PT,INR,APTT,and FIB)and higher peripheral blood TIM-3 and TAT levels compared to the mild group,while ACE2 levels were lower(P<0.05).Similarly,the secondary OF group showed markedly higher coagulation function indices and peripheral blood TIM-3 and TAT levels than the non-OF group,with lower ACE2 levels(P<0.05).Multifactorial analysis indicated that PT,INR,APTT,FIB,TIM-3,TAT,and ACE2 influenced the onset of secondary organ failure.The area under the ROC curve for secondary organ failure was 0.846,0.926,0.819,0.862,0.751,0.847,and 0.858 for PT,INR,APTT,FIB,TIM-3,TAT,and ACE2,respectively.Conclusion:In patients with acute pancreatitis,abnormal coagulation and elevation of TIM-3,TAT and decreased ACE 2 in peripheral blood are strongly associated with disease severity,with potential predictive value for the risk of organ failure secondary to acute pancreatitis.

关 键 词：急性胰腺炎 器官功能衰竭 凝血功能 T细胞免疫球蛋白黏蛋白分子3 凝血酶-抗凝血酶复合物 血管紧张素转换酶2 

分 类 号：R576[医药卫生—消化系统] R459.7[医药卫生—内科学]