摘要
目的探讨急性胰腺炎(AP)患者血清成纤维细胞生长因子21(FGF21)、摄食抑制因子-1(Nesfatin-1)水平与病情严重程度及预后的关系。方法选取2018年1月至2024年5月上海交通大学医学院附属第九人民医院收治的AP患者280例(AP组)和体检健康者140名(对照组);AP患者根据病情严重程度分为轻症AP组(72例)、中度重症AP组(98例)、重症AP组(110例);根据院内生存状态分为死亡组(52例)和存活组(228例)。比较各组血清FGF21、Nesfatin-1水平;分析AP患者预后的影响因素,并评估血清FGF21、Nesfatin-1水平对其预测价值。结果AP组血清FGF21水平高于对照组,Nesfatin-1水平低于对照组(P<0.05)。重症AP组血清FGF21水平高于中度重症AP组、轻症AP组,Nesfatin-1水平低于中度重症AP组、轻症AP组(P<0.05);中度重症AP组血清FGF21水平高于轻症AP组,Nesfatin-1水平低于轻症AP组(P<0.05)。死亡组与存活组病情严重程度、重症监护室(ICU)停留时间、C反应蛋白(CRP)、FGF21、Nesfatin-1比较,差异有统计学意义(P<0.05)。重症(OR=5.351)、ICU停留时间延长(OR=1.260)、CRP升高(OR=1.016)、FGF21升高(OR=1.004)为AP患者预后的独立危险因素,Nesfatin-1升高(OR=0.813)为独立保护因素(P<0.05)。血清FGF21联合Nesfatin-1预测AP患者预后的曲线下面积高于各指标单独预测(P<0.05)。结论血清FGF21水平升高、Nesfatin-1水平降低与AP患者病情加重及不良预后相关,联合检测对不良预后具有较高的预测价值。
Objective To investigate the relationship between the serum fibroblast growth factor 21(FGF21)and Nesfatin-1 levels and severity and prognosis in patients with acute pancreatitis(AP).Methods A total of 280 patients with AP(AP group)and 140 healthy subjects(control group)admitted to Shanghai Ninth People’s Hospital,Shanghai Jiao Tong University School of Medicine from January 2018 to May 2024 were selected;according to the severity of the disease,AP patients were divided into mild AP group(72 cases),moderate severe AP group(98 cases),and severe AP group(110 cases);according to the in-hospital survival status,they were divided into death group(52 cases)and survival group(228 cases).Serum FGF21 and Nesfatin-1 levels were compared across the groups.The influencing factors of prognosis in AP patients were analyzed,and the predictive value of serum FGF21 and Nesfatin-1 levels was evaluated.Results The serum FGF21 level in AP group was higher than that in control group,while Nesfatin-1 level was lower than that in control group(P<0.05).The serum FGF21 level in severe AP group was higher than that in moderately severe AP group and mild AP group,while Nesfatin-1 level was lower than that in moderately severe AP group and mild AP group(P<0.05);the serum FGF21 level of moderately severe AP group were higher than those of mild AP group,while Nesfatin-1 level was lower than that in mild AP group(P<0.05).There were significant differences in the severity of disease,stay time in intensive care unit(ICU),C-reactive protein(CRP),FGF21,and Nesfatin-1 between death group and survival group(P<0.05).Severe disease(OR=5.351),prolonged stay time in ICU(OR=1.260),CRP increase(OR=1.016),and FGF21 increase(OR=1.004)were independent risk factors for the prognosis of AP patients;Nesfatin-1 increase(OR=0.813)was an independent protective factor(P<0.05).The area under the curve of serum FGF21 combined with Nesfatin-1 predicted the prognosis of AP patients was higher than that predicted by each indicator alone(P<0.05).Conclusion The increase of serum FGF21 level and the decrease of Nesfatin-1 level are associated with the aggravation and poor prognosis of AP patients,and the combined detection had high predictive value for the poor prognosis.
作者
王雷
张志飞
应佑国
丁艳芬
董锦秀
袁慧敏
WANG Lei;ZHANG Zhifei;YING Youguo;DING Yanfen;DONG Jinxiu;YUAN Huimin(Department of Emergency,Shanghai Ninth People’s Hospital,Shanghai Jiao Tong University School of Medicine,Shanghai201999,China)
出处
《中国医药导报》
2025年第6期124-128,共5页
China Medical Herald
基金
上海市卫生健康委员会卫生行业临床研究专项项目(202040137)。
