摘要
目的了解急性胰腺炎患者血清Ghrelin水平变化对病情严重程度判断的价值。方法收集急性胰腺炎患者入院时、人院后48h和出院时外周血标本，依据急性生理与慢性健康评分（APACHE）II评分／〉8，RANSON评分≥3分，CT评分≥4分，将患者分为轻型组、重型组，采用酶联免疫吸附法测定血清Ghrelin水平；并与APACHEII评分、C反应蛋白（CRP）作相关性分析，对血清Ghrelin水平作ROC曲线分析。结果本研究共入组患者47例，其中重型胰腺炎组17例，轻型胰腺炎组30例。血清Ghrelin水平在入院24h两组分别为（358．6±119．3）ng／L与（212．1±42．7）ng／L，P〈0．001，48h后分别为（253．1±71．2）与（275．5±73．6）ng／L，P=0．572，出院时为（327．8±103．8）与（319．4±87．1）ng／L，P=0．816。血清Ghrelin水平与APACHEII评分、CRP呈正相关，ROC曲线面积0．8414-0．057，95％可信区间为0．729—0．952。P〈0．001。结论血清Ghrelin水平在急性胰腺炎早期两组之间具有明显差异，可以作为早期预测胰腺坏死程度及临床严重程度的标志物之一。
Objective To explore the value of altered serum level of Ghrelin for severity assessment in patients with acute pancreatitis （AP）. Methods Peripheral blood samples were collected from 47 AP patients at admission, 48 hours post-admission and at discharge. According to the criteria of APACHE 11 score ≥8, RANSON ≥ 3, CT ≥ 4, they were divided into mild （n = 17） and severe （n =30） groups. Enzyme-linked immunosorbent assay （ELISA） was used to measure the serum level of Ghrelin. And correlation analysis was made with the score of APACHE I1 and the level of C reactive protein （CRP）. Also the serum level of Ghrelin was analyzed with receiver operating characteristic （ROC） curve. Results The serum levels of Ghrelin after 24 h were 358.6 ± 119.3 vs 212. 1 ± 42. 7 ng/L （P 〈 0. 001 ） ; after 48 hours, 253.1±71.2 vs 275.5 ±73.6 ng/L （P =0.572） ; at discharge, 327.8 ± 103.8 vs 319.4±87.1 ng/L respectively （P = 0. 816）. And serum level of Ghrelin was positively correlated with APACHE 11 and C RP. ROC area under curve was 0. 841 ± 0. 057 and 95% confidence interval 0. 729 - 0. 952 （ P 〈 0. 001 ）. Conclusion The serum level of Ghrelin during early-stage AP has significant differences between two groups. And it may become an early predictor of pancreatic necrosis and a degree marker of clinical severity.
出处
《中华医学杂志》
CAS
CSCD
北大核心
2013年第48期3864-3866,共3页
National Medical Journal of China
