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血浆可溶性尿激酶型纤溶酶原激活物受体对重症急性胰腺炎的预测价值
Predictive value of soluble urokinase-type plasminogen activator receptor in patients with severe acute pancreatitis
- 陆军军医大学学报 2022年44卷第3期 页码：241-245
- 作者机构：
400038 重庆，陆军军医大学(第三军医大学)第一附属医院急救部
- 作者简介：
[ 向强，E-mail：Xqiang163@163.com XIANG Qiang, E-mail: Xqiang163@163.com
- 基金信息：重庆市技术创新与应用发展专项面上项目(cstc2019jscx-msxmX0222);陆军军医大学科技创新能力提升专项项目(2019XLC3001)
DOI：10.16016/j.2097-0927.202107019
中图分类号： R181.32;R446.112;R576收稿：2021-07-03，
修回：2021-11-09，
纸质出版：2022-02-15
- 稿件说明：
移动端阅览
李杨, 赵胤杰, 余海燕, 等. 血浆可溶性尿激酶型纤溶酶原激活物受体对重症急性胰腺炎的预测价值[J]. 陆军军医大学学报, 2022,44(3):241-245.
Yang LI, Yinjie ZHAO, Haiyan YU, et al. Predictive value of soluble urokinase-type plasminogen activator receptor in patients with severe acute pancreatitis[J]. Journal of Army Medical University, 2022, 44(3): 241-245.
李杨, 赵胤杰, 余海燕, 等. 血浆可溶性尿激酶型纤溶酶原激活物受体对重症急性胰腺炎的预测价值[J]. 陆军军医大学学报, 2022,44(3):241-245. DOI： 10.16016/j.2097-0927.202107019.
Yang LI, Yinjie ZHAO, Haiyan YU, et al. Predictive value of soluble urokinase-type plasminogen activator receptor in patients with severe acute pancreatitis[J]. Journal of Army Medical University, 2022, 44(3): 241-245. DOI： 10.16016/j.2097-0927.202107019.
摘要
目的
2
探讨可溶性尿激酶型纤溶酶原激活物受体(soluble urokinase-type plasminogen activator receptor，suPAR)对重症急性胰腺炎(acute severe pancreatitis，SAP)的预测价值。
方法
2
采用前瞻性队列研究设计，纳入2021年3月1日至6月1日我科收治的急性胰腺炎患者103例[其中SAP 23例，非重症急性胰腺炎(non severe acute pancreatitis
NSAP)80例
]
，采集患者入院即刻血浆样本。同时，招募同期健康体检者30例作为对照组。采用酶联免疫吸附试验检测所有受试者血浆suPAR水平。收集急性胰腺炎患者的一般临床资料及降钙素原(procalcitonin，PCT)、白介素-6(interleukin-6，IL-6)、C反应蛋白(C-reactive protein，CRP)、D-二聚体、血清钙(calcium，Ca
2+
)水平以及血常规、血生化检查结果，并计算急性生理学与慢性健康状况评分系统Ⅱ(acute physiology and chronic health evaluation
APACHE Ⅱ)评分和Ranson’s评分。记录对照组受试者人口学特征(年龄和性别)。采用Pearson相关分析suPAR与APACHE II评分、Ranson’s评分的相关性；采用多因素Logistic回归分析SAP的独立预测因素；采用受试者工作特征(receiver op
erating characteristic，ROC)曲线下面积(area under the curve，AUC)评估上述各独立预测因素对SAP的预测价值。
结果
2
相较于对照组，NSAP及SAP患者血浆suPAR水平明显升高(
P
＜0.05)，SAP患者suPAR水平明显高于NSAP患者(
P
＜0.05)。急性胰腺炎患者血浆suPAR水平与APACHE Ⅱ评分、Ranson’s评分呈正相关(
R
=0.554、
R
=0.485，
P
＜0.05)，多因素Logistic回归分析表明suPAR、D-二聚体、Ca
2+
是SAP的独立预测因素，ROC曲线分析显示血浆suPAR对SAP有较好的预测价值(AUC=0.869)。
结论
2
血浆suPAR水平与急性胰腺炎患者病情严重程度相关，对预测SAP具有重要价值。
Abstract
Objective
2
To explore the predictive value of soluble urokinase-type plasminogen activator receptor (suPAR) for severe acute pancreatitis (SAP).
Methods
2
A prospective cohort study was designed to enroll 103 patients with acute pancreatitis who were admitted to our department from March 1 to June 1
2021
including 23 SAP and 80 non-severe acute pancreatitis (NSAP). Another 30 healthy subjects were recruited concurrently as control group. The plasma samples of all subjects were collected on the first day of admission to detect the level of suPAR using ELISA. General clinical data and the levels of procalcitonin (PCT)
interleukin-6 (IL-6)
C-reactive protein (CRP)
D-dimer and serum calcium (Ca
2+
)
as well as the results of blood routine and biochemical examinations of patients were all collected. Acute Physiology and Chronic Health Evaluation (APACHEⅡ) score and Ranson's score were subsequently calculated. For the control subjects
only their demographic characteristics (age and gender) were collected. Statistical analysis was adopted on the above data.
Results
2
The plasma suPAR level was significantly higher in the patients with NSAP and SAP than the control group (
P
<
0.05)
and also notably higher in those of the SAP group than those out of the NSAP patients (
P
<
0.05). Pearson correlation ana
lysis showed that plasma suPAR level was positively correlated with both APACHE Ⅱ score and Ranson's score (
R
=0.554
R
=0.485
P
<
0.05). Multivariate Logistic regression analysis indicated that suPAR
D-dimer and Ca
2+
levels were independent predictors of SAP. ROC curve demonstrated that serum suPAR had a good predictive value for SAP (AUC=0.869).
Conclusion
2
The plasma level of suPAR is closely correlated with the severity of acute pancreatitis
and plays an important role in prediction of SAP.
关键词
Keywords
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