血清GPC-4、PIVKA-Ⅱ水平对急性胆源性胰腺炎患者疾病转归的预测价值  

Prognostic value of serum GPC-4 and PIVKA-Ⅱlevels on disease outcome in patients with acute biliary pancreatitis

作　　者：周文勇[1] 王欣 孙月 闫斌 ZHOU Wenyong;WANG Xin;SUN Yue;YAN Bin(Cangzhou Central Hospital,Cangzhou 061017,Hebei,China;Cangzhou Integrated Traditional Chinese and Western Medicine Hospital of Hebei,Cangzhou 061000,Hebei,China)

机构地区：[1]沧州市中心医院,河北沧州061017 [2]河北省沧州中西医结合医院,河北沧州061000

出　　处：《中南医学科学杂志》2025年第1期85-88,共4页Medical Science Journal of Central South China

基　　金：河北省医学科学研究课题项目(20211618)。

摘　　要：目的研究血清磷脂酰肌醇蛋白聚糖-4(GPC-4)、异常凝血酶原即维生素K缺乏或拮抗剂Ⅱ诱导蛋白(PIVKA-Ⅱ)水平对急性胆源性胰腺炎患者疾病转归的预测价值。方法选择急性胆源性胰腺炎患者113例为观察组,根据急性生理学与慢性健康评分系统Ⅱ(APACHEⅡ)分为轻度组(n=69)和中重度组(n=44),根据疾病转归分为恶化组(n=32)和好转组(n=81);另选择同期体检健康者92例为对照组。比较各组血清GPC-4、PIVKA-Ⅱ水平。分析各指标的相关性、疾病转归的影响因素以及GPC-4、PIVKA-Ⅱ对疾病转归的预测价值。结果观察组血清PCT、CRP、GPC-4、PIVKA-Ⅱ、APACHEⅡ评分均高于对照组,中重度组高于轻度组,恶化组高于好转组(P<0.05)。Pearson相关分析显示,血清GPC-4、PIVKA-Ⅱ与APACHEⅡ评分均呈正相关(P<0.001)。多因素Logistic回归分析显示,血清GPC-4、PIVKA-Ⅱ、APACHEⅡ评分是急性胆源性胰腺炎疾病转归的危险因素(P<0.05)。ROC曲线分析显示,血清GPC-4、PIVKA-Ⅱ二者联合检测对急性胆源性胰腺炎疾病转归具有良好的预测价值(P<0.05)。结论急性胆源性胰腺炎患者血清GPC-4、PIVKA-Ⅱ水平对其疾病转归具有良好的预测价值。Aim To investigate the predictive value of serum levels of glypican-4(GPC-4),abnormal prothrombin,i.e.,protein induced by vitamin K deficiency or antagonist-Ⅱ(PIVKA-Ⅱ),on disease outcome in patients with acute biliary pancreatitis.Methods 113 patients with acute biliary pancreatitis were selected as observation group,and were divided into mild group(n=69)and moderate and severe group(n=44)according to acute physiology and Chronic Health Score SystemⅡ(APACHEⅡ),or divided into worsening group(n=32)and improvement group(n=81)according to disease outcome.In addition,92 healthy subjects were selected as control group.Serum levels of GPC-4 and PIVKA-Ⅱwere compared among all groups.The correlation of each index,the influencing factors of disease outcome and the predictive value of GPC-4 and PIVKA-Ⅱfor disease outcome were analyzed.Results Serum PCT,CRP,GPC-4,PIVKA-Ⅱand APACHEⅡscores in observation group were higher than those in control group,higher in moderate to severe group compared with mild group,and higher in worsening group compared with improvement group(P<0.05).Pearson correlation analysis showed that serum GPC-4,PIVKA-Ⅱand APACHEⅡscores were positively correlated(P<0.001).Multivariate Logistic regression analysis showed that serum GPC-4,PIVKA-Ⅱand APACHEⅡscores were risk factors for the outcome of acute biliary pancreatitis(P<0.05).ROC curve analysis showed that the combined detection of serum GPC-4 and PIVKA-Ⅱhad a good predictive value for the outcome of acute biliary pancreatitis(P<0.05).Conclusion Serum levels of GPC-4 and PIVKA-Ⅱin patients with acute biliary pancreatitis have good predictive value for their disease outcomes.

关 键 词：GPC-4 PIVKA-Ⅱ 急性胆源性胰腺炎 疾病转归 

分 类 号：R576[医药卫生—消化系统]