血清C3aR1、BATF水平与重症急性胰腺炎患者疾病转归的关系  

Relationship between serum C3aR1,BATF levels and the prognosis of patients with severe acute pancreatitis

作　　者：邢斌瑜 申存毅[1] 林婷[1] 李晓宁[1] 王文静[1] 张维[1] 谭文君[1] Xing Binyu;Shen Cunyi;Lin Ting;Li Xiaoning;Wang Wenjing;Zhang Wei;Tan Wenjun(Department of Surgical Critical Care Medicine,The First Affiliated Hospital of Xi'an Jiaotong University,Xi'an 710000,China)

机构地区：[1]西安交通大学第一附属医院外科重症医学科,西安710000

出　　处：《保健医学研究与实践》2024年第10期75-80,共6页Health Medicine Research and Practice

基　　金：陕西省重点研发计划项目(2023-YBSF-421)。

摘　　要：目的探讨C3a受体1(C3aR1)、B细胞转录激活因子(BATF)水平与重症急性胰腺炎患者疾病转归的关系,以期为临床治疗提供参考。方法选取2020年6月—2023年6月西安交通大学第一附属医院收治的247例急性胰腺炎患者作为研究对象。根据病情分为轻症组(无器官衰竭及无局部并发症,n=135)、重症组(持续性器官衰竭且伴有局部并发症,n=112)。根据112例重症急性胰腺炎患者在治疗28 d后的转归情况分为恶化组(n=33)与好转组(n=79)。另将同期140例健康体检者作为对照组。比较各组一般资料及C3aR1、BATF水平;采用受试者工作特征曲线(ROC)评估C3aR1、BATF水平预估重症急性胰腺炎患者疾病转归的价值;采用多因素logistic回归分析重症急性胰腺炎患者疾病转归的影响因素。结果重症组患者APACHEⅡ评分及白细胞计数(WBC)、C-反应蛋白(CRP)、淀粉酶(AMY)、脂肪酶(LPS)水平均高于轻症组、对照组研究对象,白蛋白(Alb)水平低于轻症组、对照组研究对象,差异均有统计学意义(P<0.05);轻症组患者APACHEⅡ评分及WBC、CRP、AMY、LPS水平均高于对照组研究对象,Alb水平低于对照组研究对象,差异均有统计学意义(P<0.05)。重症组患者C3aR1、BATF水平均高于轻症组,差异均有统计学意义(P<0.05)。ROC曲线分析显示,C3aR1、BATF及二者联合(串联)预估重症急性胰腺炎疾病转归的曲线下面积(AUC)(95%CI)分别为0.844(0.794~0.894)、0.860(0.810~0.910)及0.917(0.867~0.967)。二分类logistic逐步回归分析结果显示,APACHEⅡ评分>8.00分(OR=2.617,95%CI:1.600~4.280)、C3aR1≥3.55 mg/L(OR=3.762,95%CI:1.947~7.269)、BATF≥33.44μg/L(OR=4.250,95%CI:2.002~9.022)均为影响重症急性胰腺炎疾病转归的危险因素(P<0.05)。结论C3aR1、BATF水平在重症急性胰腺炎患者中均表达升高,且水平变化与疾病转归密切相关,是疾病转归不良的危险因素,二者联合对重症急性胰腺炎患者疾病转归的预估具有�Objective To explore the relationship between the levels of C3a receptor 1(C3aR1)and B-cell activating factor(BATF)and the prognosis of patients with severe acute pancreatitis,aiming to provide a reference for clinical treatment.Methods A total of 247 patients with acute pancreatitis treated at the First Affiliated Hospital of Xi'an Jiaotong University from June 2020 to June 2023 were selected as the study participants.Patients were assigned to a mild group(absence of organ failure and local complications,n=135)and a severe group(presence of persistent organ failure with local complications,n=112).The 112 patients with severe acute pancreatitis were further assigned to a deterioration group(n=33)and an improvement group(n=79)based on their condition after 28 days of treatment.Additionally,140 healthy individuals who underwent physical examinations during the same period were included as the control group.The general information and levels of C3aR1 and BATF were compared among the groups.The receiver operating characteristic(ROC)curve was used to evaluate the predictive value of C3aR1 and BATF levels for the prognosis of patients with severe acute pancreatitis.Multivariate logistic regression analysis was used to identify factors affecting the prognosis of these patients.Results The Acute Physiology and Chronic Health Evaluation Ⅱ(APACHEⅡ)scores and white blood cell count(WBC),C-reactive protein(CRP),amylase(AMY),and lipase(LPS)levels in the severe group were higher than those in the mild group and the control group,while the albumin(Alb)level was lower than those in the mild group and the control group,with statistically significant differences(P<0.05).The APACHEⅡ scores and WBC,CRP,AMY,and LPS levels in the mild group were higher than those in the control group,while the Alb level was lower than that in the control group,with statistically significant differences(P<0.05).The levels of C3aR1 and BATF in the severe group were significantly higher than those in the mild group(P<0.05).ROC curve analysis showed

关 键 词：重症急性胰腺炎 B细胞转录激活因子 补体C3a受体1 疾病转归 

分 类 号：R576[医药卫生—消化系统]