摘要
目的探讨急性胰腺炎(AP)患者早期血清D-乳酸、内毒素、二胺氧化酶(DAO)水平及临床意义。方法选取2016年3月至2018年12月该院收治的AP患者109例为AP组,依据患者病情严重程度分为轻度AP组(n=54)和重度AP组(n=55);另选取同期在该院进行健康体检者50例为对照组,比较AP组与对照组、AP患者不同病情严重程度及各时间点血清D-乳酸、内毒素、DAO水平,采用Spearman相关性分析病情严重程度与D-乳酸、内毒素、DAO水平的相关性。采用受试者工作特征曲线(ROC)评价D-乳酸、内毒素、DAO对不同病情严重程度的AP患者的诊断价值。结果AP组患者入院当天血清D-乳酸、内毒素、DAO水平明显高于对照组(P<0.05)。入院当天及入院3、5、7 d后重度AP组患者血清D-乳酸、内毒素、DAO水平均高于轻度AP组(P<0.05),轻度AP组各指标随入院时间的增长持续降低,而重度AP组患者各指标在入院3 d后达到峰值,此后依次降低(P<0.05)。经Spearman相关性分析显示,AP患者血清D-乳酸、内毒素、DAO水平与不同病情严重程度呈正相关(P<0.05)。ROC曲线结果显示,诊断阈值经模拟平滑运算,血清D-乳酸、内毒素、DAO水平分别为38.45 mg/L、28.14 U/L、40.12 U/L;在此阈值处,AUC分别为0.722、0.790、0.669,灵敏度和特异度均在70%左右。结论AP患者血清D-乳酸、内毒素、DAO水平偏高,与病情严重程度密切相关,可为该病诊断、病情判断、疗效评估提供依据。
Objective To investigate the levels and clinical significance of serum D-lactic acid,endotoxin and diamine oxidase(DAO)at early stage in the patients with acute pancreatitis(AP).Methods A total of 109 patients with AP treated in this hospital from March 2016 to December 2018 were selected as the AP group.All cases were divided into the mild AP group(n=54)and severe AP group(n=55)according to the severity of the disease.Contemporaneous other 50 subjects undergoing the healthy physical examination in this hospital were selected as the control group.The levels of serum D-lactic acid,endotoxin and DAO were compared between the AP group and control group,and among different severity degrees and different time points.The Spearman correlation analysis was adopted to analyze the correlation between the disease severity and the levels of D-lactic acid,endotoxin and DAO.The receiver operating characteristic(ROC)curve was adopted to evaluate the diagnostic value of D-lactic acid,endotoxin and DAO in AP patients with different severity degrees.Results The levels of serum D-lactic acid,endotoxin and DAO on the admission day in the AP group were significantly higher than those in the control group(P<0.05).Serum D-lactic acid,endotoxin and DAO levels on the admission day,3,5,7 d after admission in severe AP group were higher than those in the mild AP group(P<0.05).The various indicators in the mild AP group continued to decrease with the increase of hospitalization time,while those in the severe AP group reached the peak value on 3 d after admission,and then decreased in turn(P<0.05).The Spearman correlation analysis showed that serum D-lactic acid,endotoxin and DAO levels were positively correlated with the different severity degrees of AP(P<0.05).The ROC curve results showed that the diagnostic thresholds of serum D-lactic acid,endotoxin and DAO by simulation smoothing calculation were 38.45 mg/L,28.14 U/L and 40.12 U/L respectively.At these threshold points,AUC were 0.722,0.790 and 0.669 respectively,and the sensitivity and specificity were about 70%.Conclusion Serum D-lactic acid,endotoxin and DAO levels in AP patients are relatively high,which are closely correlated to the severity degree of the disease,and can provide the basis for the diagnosis,disease condition judgment and evaluation of the curative effect.
作者
谢齐贵
陈湛蕾
朱世峰
夏亮
XIE Qigui;CHEN Zhanlei;ZHU Shifeng;XIA Liang(Department of Digestion,Zhejiang Provincial Tongde Hospital,Hangzhou,Zhejiang 230032,China)
出处
《重庆医学》
CAS
2020年第9期1421-1424,共4页
Chongqing medicine
基金
浙江省中医药科技计划项目(2016ZB001)。
关键词
急性胰腺炎
D-乳酸
内毒素类
二胺氧化酶
临床意义
acute pancreatitis
D-lactic acid
endotoxin
diamine oxidase
clinical significance
