不同严重程度急性胰腺炎患者血清MMP-9、SAA、TPS-2水平比较  

Comparison of serum levels of MMP-9,SAA and TPS-2 in patients with acute pancreatitis of different severity

作　　者：王臣臣 邹雪飞 陈楠 WANG Chen-chen;ZOU Xue-fei;CHEN Nan(Department of Gastroenterology,Liaocheng People′s Hospital,Shandong Province,Liaocheng 252000,China)

机构地区：[1]山东省聊城市人民医院消化内科,山东聊城252000

出　　处：《河北医科大学学报》2025年第3期304-308,共5页Journal of Hebei Medical University

基　　金：山东省医药卫生科技发展计划项目(202006011279)。

摘　　要：目的探讨不同严重程度急性胰腺炎患者血清基质金属蛋白酶9(matrix metalloproteinase-9,MMP-9)、淀粉样蛋白A(serum amyloid A,SAA)、胰蛋白酶原2(trypsinogen-2,TPS-2)水平变化。方法回顾性分析山东省聊城市人民医院收治的急性胰腺炎患者84例的临床资料,根据患者急性生理与慢性健康状况Ⅱ(Acute Physiology and Chronic Health EvaluationⅡ,APACHEⅡ)评分将患者分为重症组(APACHEⅡ评分≥8分)和轻症组(APACHEⅡ评分<8分),分别为30例和54例,另选健康体检者50例为对照。比较患者组与对照组MMP-9、SAA、TPS-2差异,观察不同严重程度患者一般资料及血清MMP-9、SAA、TPS-2水平,通过多因素Logistic回归分析明确急性胰腺炎患者病情发展为重症的危险因素,通过受试者工作特征曲线(receiver operating characteristic curve,ROC)分析血清MMP-9、SAA、TPS-2预测重症急性胰腺炎的价值。结果患者组血清MMP-9、SAA、TPS-2水平均显著高于对照组(P<0.05)。重症组血清MMP-9、SAA、TPS-2水平分别为(610.48±178.25)μg/L、(597.67±168.49)mg/L、(244.56±80.11)kU/L均显著高于轻症组(346.77±113.23)μg/L、(339.78±107.66)mg/L、(64.76±21.07)kU/L(P<0.05)。多因素Logistic回归性分析结果显示,血清MMP-9(OR=2.688,95%CI:1.351~5.348)、SAA(OR=3.273,95%CI:1.509~7.099)、TPS-2(OR=2.817,95%CI:1.418~5.596)水平较高是急性胰腺炎患者病情发展为重症的危险因素(P<0.05)。经ROC分析,血清MMP-9、SAA、TPS-2预测重症急性胰腺炎的曲线下面积分别为0.831、0.888、0.841,敏感度分别为0.767、0.800、0.733,特异度分别为0.833、0.926、0.870,P<0.05。结论血清MMP-9、SAA、TPS-2水平能在一定程度上预测急性胰腺炎患者的病情严重程度,可作为预测重症急性胰腺炎的血清指标。Objective To investigate the changes of serum matrix metalloproteinase-9(MMP-9),serum amyloid A(SAA)and trypsinogen-2(TPS-2)levels in patients with acute pancreatitis(AP)of different severity.Methods A retrospective analysis was conducted on the clinical data of 84 patients with AP admitted to Liaocheng People′s Hospital in Shandong Province.Based on their Acute Physiology and Chronic Health EvaluationⅡ(APACHEⅡ)scores,the patients were divided into the severe group(APACHEⅡscore≥8 points,n=30)and the mild group(APACHEⅡscore<8 points,n=54).Additionally,50 healthy physical examinees were selected as controls.The differences in MMP-9,SAA,and TPS-2 between the patient group and the control group were compared,and the general information and serum MMP-9,SAA,and TPS-2 levels of patients with different severity were observed.The risk factors for the progression of AP to severe AP were identified through multiple Logistic regression analysis.Receiver operating characteristic(ROC)curve was used to analyze the value of serum MMP-9,SAA,and TPS-2 in predicting severe AP.Results Serum levels of MMP-9,SAA and TPS-2 in patient group were significantly higher than those in control group(P<0.05).The serum levels of MMP-9,SAA and TPS-2 in the severe group were(610.48±178.25)μg/L,(597.67±168.49)mg/L and(244.56±80.11)kU/L,respectively,which were significantly higher than those in the mild group[(346.77±113.23)μg/L,(339.78±107.66)mg/L,(64.76±21.07)kU/L](P<0.05).Multivariate Logistic regression analysis showed that high levels of serum MMP-9(OR=2.688,95%CI:1.351-5.348),SAA(OR=3.273,95%CI:1.509-7.099),and TPS-2(OR=2.817,95%CI:1.418-5.596)were the risk factors for the progression ofAP to severe AP in patients(P<0.05).ROC analysis showed that the area under the ROC curve(AUC)of serum MMP-9,SAA and TPS-2 in predicting severe AP was 0.831,0.888 and 0.841,respectively,the sensitivity was 0.767,0.800 and 0.733,respectively,and the specificity was 0.833,0.926 and 0.870,respectively(all with P<0.05).Conclusion Serum MMP-9,SA

关 键 词：急性胰腺炎 基质金属蛋白酶9 淀粉样蛋白A 胰蛋白酶原2 

分 类 号：R576[医药卫生—消化系统]