外周血单个核细胞中ITGAM、ITGB2水平在重症急性胰腺炎患者并发急性肺损伤诊断及预后评估中的价值  

Value of ITGAM and ITGB2 levels in peripheral blood mononuclear cells in the diagnosis and prognosis evaluation for patients with severe acute pancreatitis complicated with acute lung injury

作　　者：徐贤彪 邵杰 杨明芳 李瑞丹 汪雅琴 张丽 XU Xianbiao;SHAO Jie;YANG Mingfang;LI Ruidan;WANG Yaqin;ZHANG Li(Respiratory and Critical Care Medicine,Ordnance Industry General Hospital,Xi'an,Shaanxi 710065,China)

机构地区：[1]兵器工业总医院呼吸与危重症医学科,陕西西安710065

出　　处：《国际检验医学杂志》2025年第8期904-909,共6页International Journal of Laboratory Medicine

基　　金：陕西省重点研发计划项目(2019SF-043)。

摘　　要：目的探究外周血单个核细胞(PBMC)中整合素αM(ITGAM)、整合素β2(ITGB2)水平在重症急性胰腺炎(SAP)患者并发急性肺损伤(ALI)诊断及预后评估中的价值。方法选取2022年11月至2024年2月该院收治的SAP患者205例,根据是否并发ALI,将其分为ALI组(103例)和无ALI组(102例)。同时选取110例体检健康者作为对照组。比较不同组别PBMC中ITGAM、ITGB2水平差异。采用Logistic回归分析SAP患者并发ALI的影响因素。采用受试者工作特征(ROC)曲线分析PBMC中ITGAM、ITGB2水平对SAP并发ALI的诊断价值及对预后不良的预测价值。结果ALI组PBMC中ITGAM、ITGB2及血淀粉酶、尿淀粉酶水平较无ALI组和对照组升高(P<0.05)。多因素Logistic回归分析显示,ITGAM、ITGB2及血淀粉酶水平升高是SAP患者并发ALI的危险因素(P<0.05)。ROC曲线显示,ITGAM、ITGB2联合诊断SAP患者并发ALI的曲线下面积(AUC)明显大于ITGAM、ITGB2单项诊断(P<0.05)。预后不良组PBMC中ITGAM、ITGB2水平较预后良好组升高(P<0.05)。ROC曲线显示,ITGAM、ITGB2联合预测SAP并发ALI患者预后不良的AUC明显大于ITGAM、ITGB2单项预测(P<0.05)。结论PBMC中ITGAM、ITGB2水平升高是SAP患者并发ALI的危险因素。同时,ITGAM联合ITGB2对SAP并发ALI患者预后不良具有较好的预测效能,对临床实践具有重要价值,有望成为潜在的生物标志物。Objective To investigate the value of integrin subunitαM(ITGAM)and integrin subunitβ2(ITGB2)levels in peripheral blood mononuclear cells(PBMC)in the diagnosis and prognosis evaluation for patients with severe acute pancreatitis(SAP)complicated with acute lung injury(ALI).Methods A total of 205 patients with SAP admitted from November 2022 to February 2024 in the hospital were selected,and they were divided into ALI group(103 cases)and non-ALI group(102 cases)according to whether they were complicated with ALI.Meanwhile,110 healthy people who underwent the physical examination were selected as the control group.The differences of the levels of ITGAM and ITGB2 in PBMC in different groups were compared.Logistic regression was used to analyze the influencing factors for ALI in patients with SAP.The receiver operating characteristic(ROC)curve was used to analyze the diagnostic value of levels of ITGAM and ITGB2 in PBMC for SAP patients complicated with ALI and the predictive value for poor prognosis.Results The levels of ITGAM,ITGB2 in PBMC,and serum amylase and urine amylase levels in ALI group were higher than those in non-ALI group and control group(P<0.05).Multivariate Logistic regression analysis showed that the increase of ITGAM,ITGB2 and serum amylase levels were risk factors for ALI in patients with SAP(P<0.05).ROC curve results showed that the area under the curve(AUC)of ITGAM combined with ITGB2 in diagnosing ALI in patients with SAP was significantly higher than those of ITGAM and ITGB2 alone(P<0.05).The levels of ITGAM and ITGB2 in PBMC in the poor prognosis group were higher than those in the good prognosis group(P<0.05).ROC curve results showed that the AUC of ITGAM combined with ITGB2 in predicting poor prognosis in patients with SAP complicated with ALI was significantly higher than those of ITGAM and ITGB2 alone(P<0.05).Conclusion Increased levels of ITGAM and ITGB2 in PBMC are risk factors for ALI in patients with SAP.ITGAM combined with ITGB2 has a good predictive efficacy for the poor prognosis i

关 键 词：重症急性胰腺炎 急性肺损伤 整合素αM 整合素β2 预后 

分 类 号：R576[医药卫生—消化系统]