摘要
目的检测重型急性胰腺炎(SAP)患者血浆中趋化因子Fractalkine(FKN)及其受体CX3CR1的表达水平,判断其能否作为SAP的预测指标。方法选取2012年12月—2014年9月宁夏医科大学总医院收治的因急性上腹痛起病,症状出现在3 d以内,依据2013年《中国急性胰腺炎诊治指南》诊断为急性胰腺炎的患者65例为研究对象,其中轻型急性胰腺炎(MAP)20例(30.8%),中型急性胰腺炎(MSAP)25例(38.4%),SAP 20例(30.8%),应用酶联免疫吸附试验(ELISA)法检测患者血浆中FKN及其受体CX3CR1表达水平。比较不同病情程度急性胰腺炎患者FKN及其受体CX3CR1表达水平,绘制受试者工作特征曲线(ROC曲线),计算ROC曲线下面积(AUC),判定预测SAP的最佳截点及其灵敏度、特异度、正确率。结果不同病情程度急性胰腺炎患者FKN及其受体CX3CR1表达水平比较,差异均有统计学意义(P<0.05);其中SAP患者FKN及其受体CX3CR1表达水平高于MAP、MSAP患者(P<0.05)。FKN及其受体CX3CR1预测SAP的AUC分别为0.865、0.897,最佳截点分别为2.08μg/L和38μg/L,灵敏度分别为86.96%、90.91%,特异度分别为76.27%、88.24%,正确率分别为79.27%、89.04%。结论SAP患者FKN及其受体CX3CR1表达水平高于MAP、MSAP患者,FKN及其受体CX3CR1可作为预测急性胰腺炎严重程度的有效指标之一,值得进一步深入研究。
Objective To detect expression levels of serum Fractalkine（ FKN） and its receptor CX3CR1 of patients with severe acute pancreatitis（ SAP） and evaluate whether they could be used as the predictive indicators for SAP. Methods Enrolled 65 AP patients who had onset with acute epigastric pain in the last 3 days and were definitely diagnosed according to 2013 China guideline for AP treatment and admitted into Ningxia Medical University from December 2012 to September 2014. Among the patients,20（ 30. 8%） had mild acute pancreatitis（ MAP）, 25（ 38. 4%） had moderately severe acute pancreatitis（ MSAP）,and 20（ 30. 8%） had SAP. The expression levels of serum FKN and its receptor CX3CR1 were detected using enzyme linked immunosorbent assay（ ELISA）. Comparison was made in the expression levels of serum FKN and CX3CR1 among patients with different illness degrees. ROC curves were made,and the optimum cutoff points,sensitivity,specificity and accuracy were calculated. Results Patients with different illness degrees were significantly different in the expression levels of FKN and CX3CR1（ P〈0. 05）; SAP patients were higher than MAP patients and MSAP patients in the expression levels of FKN and CX3CR1（ P〈0. 05）. The AUC of the prediction of SAP was 0. 865 for FKN and 0. 897 for CX3CR1,and the optimum cut- off point was 2. 08 μg / L for FKN and 38 μg / L for CX3CR1. The values of sensitivity for FKN and CX3CR1 were 86. 96% and90. 91%,the values of specificity were 76. 27% and 88. 24%,and the accuracy values were 79. 27% and 89. 04%. Conclusion SAP patients are higher than MAP and MSAP patients in the expression levels of FKN and its receptor CX3CR1. The two indicators could be used to effectively predict the severity of AP,which is worth further study.
出处
《中国全科医学》
CAS
CSCD
北大核心
2015年第36期4433-4436,共4页
Chinese General Practice
基金
国家自然科学基金资助项目(81260086)
