血清Ghrelin、S100A12、IL-18水平联合检测对急性重症胰腺炎患者预后的预测价值  

Predictive value of combined detection of serum Ghrelin,S100A12,and IL-18 levels for the prognosis of acute severe pancreatitis

作　　者：魏云鹏[1] 杨宏富[1] 杜玉明[1] WEI Yun-peng;YANG Hong-fu;DU Yu-ming(Department of Critical Care Medicine,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450000,Henan,CHINA)

机构地区：[1]郑州大学第一附属医院重症医学科,河南郑州450000

出　　处：《海南医学》2024年第15期2195-2199,共5页Hainan Medical Journal

基　　金：2019年河南省医学科技攻关计划(联合共建)项目(编号:LHGJ20190213)。

摘　　要：目的探究入院时血清饥饿素(Ghrelin)、S100钙结合蛋白A12(S100A12)、白介素18(IL-18)水平与急性重症胰腺炎(ASP)严重程度的相关性及其联合检测对ASP患者预后的预测价值。方法选取2022年5月至2023年5月郑州大学第一附属医院收治的90例ASP患者设为重症组,另选取同一时段收治的90例非重症急性胰腺炎(AP)患者设为非重症组。比较两组患者入院时的血清Ghrelin、S100A12、IL-18水平、严重程度评分(BISAP评分、APACHEⅡ评分),采用Pearson相关性分析法分析重症组患者入院时血清Ghrelin、S100A12、IL-18水平与严重程度评分的相关性。重症组患者随访30 d,根据预后情况分为生存亚组62例和死亡亚组28例,比较两亚组患者入院时的血清Ghrelin、S100A12、IL-18水平,采用受试者工作特征(ROC)曲线分析入院时血清Ghrelin、S100A12、IL-18水平联合检测对ASP患者预后的预测价值。结果重症组患者入院时的血清Ghrelin、S100A12、IL-18水平,BISAP、APACHEⅡ评分分别为(642.87±53.61)ng/mL、(364.25±46.59)ng/mL、(47.38±5.41)μg/L、(4.63±0.68)分、(10.17±1.06)分,明显高于非重症组的(437.29±38.24)ng/m L、(197.68±31.67)ng/m L、(20.15±3.36)μg/L、(1.97±0.45)分、(4.35±0.89)分,差异均有统计学意义(P<0.05);Pearson相关性分析结果显示,重症组患者入院时的血清Ghrelin、S100A12、IL-18水平与BISAP、APACHEⅡ评分呈正相关(P<0.05);死亡亚组患者入院时的血清Ghrelin、S100A12、IL-18水平分别为(708.29±72.39)ng/mL、(428.95±52.61)ng/mL、(55.26±7.20)μg/L,明显高于生存亚组的(613.33±48.51)ng/mL、(335.03±41.38)ng/mL、(43.82±5.19)μg/L,差异均有统计学意义(P<0.05);ROC曲线分析结果显示,入院时血清Ghrelin、S100A12、IL-18水平联合检测预测ASP患者死亡的曲线下面积(AUC)为0.859,高于血清Ghrelin、S100A12、IL-18水平单独检测的0.724、0.729、0.716(P<0.05)。结论ASP患者入院时血清Ghrelin、S100A12、IL-18水平明显升高Objective To explore the correlation between the levels of serum Ghrelin,S100 calcium binding protein A12(S100A12),interleukin 18(IL-18)and the severity of acute severe pancreatitis(ASP)at admission,and the predictive value of combined detection for the prognosis of ASP.Methods A total of 90 patients with ASP admitted to the First Affiliated Hospital of Zhengzhou University from May 2022 to May 2023 were selected as the critical group,and 90 patients with non-severe acute pancreatitis admitted during the same period were selected as the non-critical group.Serum Ghrelin,S100A12,IL-18 levels and severity scores[bedside index for severity in acute pancreatitis(BISAP),Acute Physiology and Chronic Health EvaluationⅡ(APACHEⅡ)]at admission were compared between the two groups.Pearson correlation analysis was used to analyze the correlation of the serum Ghrelin,S100A12,IL-18 lev-els with severity scores at admission in the critical group.Patients with ASP in the critical group were followed up for 30 days and divided into survival subgroup(62 cases)and death subgroup(28 cases)according to the prognosis.Serum Ghrelin,S100A12,and IL-18 levels at admission were compared between the two subgroups.The predictive value of combined detection of serum Ghrelin,S100A12,and IL-18 levels at admission in ASP patients was analyzed by receiver operating characteristic(ROC)curve.Results The serum Ghrelin,S100A12,IL-18 levels,the scores of BISAP and APACHEⅡat admission in the critical group were(642.87±53.61)ng/mL,(364.25±46.59)ng/mL,(47.38±5.41)μg/L,(4.63±0.68)points,(10.17±1.06)points,respectively,which were significantly higher than(437.29±38.24)ng/mL,(197.68±31.67)ng/mL,(20.15±3.36)μg/L,(1.97±0.45)points,(4.35±0.89)points in the non-critical group(P<0.05).Pearson correlation analysis showed that the levels of serum Ghrelin,S100A12,and IL-18 at admission were positively correlated with BISAP and APACHEⅡscores in the critical group(P<0.05).The serum Ghrelin,S100A12,and IL-18 levels at admission in the death subgroup

关 键 词：急性重症胰腺炎 饥饿素 S100钙结合蛋白A12 白介素18 严重程度 预后 

分 类 号：R576[医药卫生—消化系统]