急性胰腺炎患者血清成纤维细胞生长因子21、摄食抑制因子-1水平与病情严重程度及预后的关系  

Relationship between the serum fibroblast growth factor 21 and Nesfatin-1 levels and the severity and prognosis of acute pancreatitis

作　　者：王雷 张志飞[1] 应佑国[1] 丁艳芬 董锦秀 袁慧敏 WANG Lei;ZHANG Zhifei;YING Youguo;DING Yanfen;DONG Jinxiu;YUAN Huimin(Department of Emergency,Shanghai Ninth People’s Hospital,Shanghai Jiao Tong University School of Medicine,Shanghai201999,China)

机构地区：[1]上海交通大学医学院附属第九人民医院急诊科,上海201999

出　　处：《中国医药导报》2025年第6期124-128,共5页China Medical Herald

基　　金：上海市卫生健康委员会卫生行业临床研究专项项目(202040137)。

摘　　要：目的探讨急性胰腺炎(AP)患者血清成纤维细胞生长因子21(FGF21)、摄食抑制因子-1(Nesfatin-1)水平与病情严重程度及预后的关系。方法选取2018年1月至2024年5月上海交通大学医学院附属第九人民医院收治的AP患者280例(AP组)和体检健康者140名(对照组);AP患者根据病情严重程度分为轻症AP组(72例)、中度重症AP组(98例)、重症AP组(110例);根据院内生存状态分为死亡组(52例)和存活组(228例)。比较各组血清FGF21、Nesfatin-1水平;分析AP患者预后的影响因素,并评估血清FGF21、Nesfatin-1水平对其预测价值。结果AP组血清FGF21水平高于对照组,Nesfatin-1水平低于对照组(P<0.05)。重症AP组血清FGF21水平高于中度重症AP组、轻症AP组,Nesfatin-1水平低于中度重症AP组、轻症AP组(P<0.05);中度重症AP组血清FGF21水平高于轻症AP组,Nesfatin-1水平低于轻症AP组(P<0.05)。死亡组与存活组病情严重程度、重症监护室(ICU)停留时间、C反应蛋白(CRP)、FGF21、Nesfatin-1比较,差异有统计学意义(P<0.05)。重症(OR=5.351)、ICU停留时间延长(OR=1.260)、CRP升高(OR=1.016)、FGF21升高(OR=1.004)为AP患者预后的独立危险因素,Nesfatin-1升高(OR=0.813)为独立保护因素(P<0.05)。血清FGF21联合Nesfatin-1预测AP患者预后的曲线下面积高于各指标单独预测(P<0.05)。结论血清FGF21水平升高、Nesfatin-1水平降低与AP患者病情加重及不良预后相关,联合检测对不良预后具有较高的预测价值。Objective To investigate the relationship between the serum fibroblast growth factor 21(FGF21)and Nesfatin-1 levels and severity and prognosis in patients with acute pancreatitis(AP).Methods A total of 280 patients with AP(AP group)and 140 healthy subjects(control group)admitted to Shanghai Ninth People’s Hospital,Shanghai Jiao Tong University School of Medicine from January 2018 to May 2024 were selected;according to the severity of the disease,AP patients were divided into mild AP group(72 cases),moderate severe AP group(98 cases),and severe AP group(110 cases);according to the in-hospital survival status,they were divided into death group(52 cases)and survival group(228 cases).Serum FGF21 and Nesfatin-1 levels were compared across the groups.The influencing factors of prognosis in AP patients were analyzed,and the predictive value of serum FGF21 and Nesfatin-1 levels was evaluated.Results The serum FGF21 level in AP group was higher than that in control group,while Nesfatin-1 level was lower than that in control group(P<0.05).The serum FGF21 level in severe AP group was higher than that in moderately severe AP group and mild AP group,while Nesfatin-1 level was lower than that in moderately severe AP group and mild AP group(P<0.05);the serum FGF21 level of moderately severe AP group were higher than those of mild AP group,while Nesfatin-1 level was lower than that in mild AP group(P<0.05).There were significant differences in the severity of disease,stay time in intensive care unit(ICU),C-reactive protein(CRP),FGF21,and Nesfatin-1 between death group and survival group(P<0.05).Severe disease(OR=5.351),prolonged stay time in ICU(OR=1.260),CRP increase(OR=1.016),and FGF21 increase(OR=1.004)were independent risk factors for the prognosis of AP patients;Nesfatin-1 increase(OR=0.813)was an independent protective factor(P<0.05).The area under the curve of serum FGF21 combined with Nesfatin-1 predicted the prognosis of AP patients was higher than that predicted by each indicator alone(P<0.05).Conclusion The increase

关 键 词：急性胰腺炎 成纤维细胞生长因子21 摄食抑制因子-1 病情严重程度 预后 

分 类 号：R657.5[医药卫生—外科学]