急性胰腺炎患者血清TSP-1和IL-1Ra水平与器官功能衰竭的相关性  

Correlation between serum levels of TSP-1,IL-1Ra,and organ failure in patients with acute pancreatitis

作　　者：许旭[1] 杨丹丹 李全福[1] XU Xu;YANG Dandan;LI Quanfu(Department of Hepatobiliary Surgery,No.2 Hospital of Baoding,Baoding 071051,China;Department of Stomatology,No.2 Hospital of Baoding,Baoding 071051,China)

机构地区：[1]保定市第二医院肝胆外科,071051 [2]保定市第二医院口腔科,071051

出　　处：《国际消化病杂志》2024年第6期398-402,418,共6页International Journal of Digestive Diseases

基　　金：河北省创新能力提升计划后补助项目(205A7705H)。

摘　　要：目的 探究急性胰腺炎(AP)患者血清血小板反应蛋白-1(TSP-1)、IL-1受体拮抗剂(IL-1Ra)水平与器官功能衰竭的相关性。方法 选择2021年10月至2023年10月保定市第二医院收治的165例AP患者作为研究对象(设为AP组),根据患者是否发生持续性器官功能衰竭(POF),将其分为非POF组(n=125)和POF组(n=40)。另选择同期该院体检中心的150名健康体检者设为对照组。采用ELISA法检测血清TSP-1、IL-1Ra水平。采用多因素logistic回归模型分析AP患者发生POF的影响因素。采用ROC曲线分析血清TSP-1、IL-1Ra水平对AP患者发生POF的预测价值。结果 与对照组相比,AP组的血清TSP-1、IL-1Ra水平均显著升高(P均<0.05)。POF组的急性生理学与慢性健康状况评分系统Ⅱ(APACHEⅡ)评分,以及C反应蛋白(CRP)、IL-6、血钙、血脂肪酶、TSP-1和IL-1Ra水平均显著高于非POF组,差异均有统计学意义(P均<0.05)。多因素logistic回归模型分析结果显示,CRP、APACHEⅡ评分、TSP-1和IL-1Ra均是AP患者发生POF的独立危险因素(P均<0.05)。血清TSP-1、IL-1Ra单独检测及联合检测预测AP患者发生POF的ROC曲线下面积(AUC)分别为0.800、0.801和0.902,提示联合检测的预测效能分别高于单独检测(P均<0.05)。结论 AP患者的血清TSP-1、IL-1Ra水平均较高,且均与POF的发生密切相关。血清TSP-1、IL-1Ra均有望作为AP诊断及预测患者发生POF的生物标志物。Objective This paper intends to investigate the correlation between serum levels of thrombospondin-1(TSP-1),interleukin-1 receptor antagonist(IL-1Ra),and organ failure in patients with acute pancreatitis(AP).Methods A total of 165 patients with AP admitted to the No.2 Hospital of Baoding from October 2021 to October 2023,were assigned to the observation group(AP group).Based on the presence of persistent organ failure(POF),patients were divided into the non-POF group(125 cases)and the POF group(40 cases).Additionally,150 healthy individuals who underwent physical examinations at the hospital were assigned to the control group.ELISA was applied to detect serum TSP-1 and IL-1Ra levels.Multivariate logistic regression was used to analyze the factors influencing POF in AP patients.ROC curve analysis was conducted to analyze the predictive value of serum TSP-1 and IL-1Ra for the occurrence of POF in AP patients.Results Compared with the control group,the levels of TSP-1 and IL-1Ra in the AP group are significantly higher(P<0.05).The APACHEⅡscore and the levels of CRP,IL-6,blood calcium,lipase,TSP-1,and IL-1Ra in the POF group are significantly higher than those in the non-POF group,with statistically significant differences(P<0.05).Multivariate logistic regression analysis shows that CRP,APACHEⅡscore,TSP-1,and IL-1Ra are independent risk factors for the occurrence of POF in AP patients(P<0.05).The area under the ROC curve(AUC)for predicting POF based on serum TSP-1 and IL-1Ra alone and in combination are 0.800,0.801,and 0.902,respectively,indicating that the combined detection both biomarkers has higher predictive efficacy than either detection alone(P<0.05).Conclusions Serum levels of TSP-1 and IL-1Ra in AP patients are elevated and are closely related to the occurrence of POF.Serum TSP-1 and IL-1Ra are expected to be biomarkers for the diagnosis and prediction of POF in AP patients.

关 键 词：急性胰腺炎 血小板反应蛋白-1 IL-1受体拮抗剂 器官功能衰竭 

分 类 号：R576[医药卫生—消化系统]