摘要
目的探讨血清前蛋白转化酶枯草杆菌蛋白酶9(PCSK9)、自噬相关基因7(ATG7)、生长分化因子-15(GDF15)对急性胰腺炎(AP)患者预后的预测价值。方法选取2021年12月至2024年12月该院收治的AP患者287例作为疾病组。另选取该院同期体检的健康志愿者142例作为健康组。采用酶联免疫吸附试验试剂盒检测血清PCSK9、ATG7、GDF15水平。急性生理学和慢性健康状况评价Ⅱ(APACHEⅡ)评分用于评价AP患者病情。使用多因素Logistic回归分析影响AP患者预后不良的因素。绘制受试者工作特征(ROC)曲线分析血清PCSK9、ATG7、GDF15水平对AP患者预后的预测价值。结果疾病组血清PCSK9、ATG7、GDF15水平高于健康组,差异有统计学意义(P<0.05)。与血清PCSK9、ATG7、GDF15低水平患者APACHEⅡ评分相比,血清PCSK9、ATG7、GDF15高水平患者APACHEⅡ评分较高,差异有统计学意义(P<0.05)。预后不良组白细胞计数、APACHEⅡ评分、血清PCSK9、ATG7、GDF15水平均大于或高于预后良好组,差异有统计学意义(P<0.05)。多因素Logistic回归分析结果显示,APACHEⅡ评分、血清PCSK9、ATG7、GDF15水平是AP患者预后不良的影响因素(P<0.05)。ROC曲线分析结果显示,血清PCSK9、ATG7、GDF15水平三者联合预测AP患者预后的曲线下面积优于单独预测(Z_(三者联合-PCSK9)=5.125、Z_(三者联合-ATG7)=4.845、Z_(三者联合-GDF15)=4.534,P<0.001)。结论AP患者血清PCSK9、ATG7、GDF15水平升高,三者联合预测AP患者预后具有较高的临床价值。
Objective To explore the predictive value of serum proprotein convertase subtilisin/kexin type 9(PCSK9),autophagy-related gene 7(ATG7),and growth differentiation factor-15(GDF15)for the prognosis of patients with acute pancreatitis(AP).Methods A total of 287 patients with AP admitted to the hospital from December 2021 to December 2024 were selected as the disease group.Another 142 healthy volunteers who underwent physical examinations in our hospital during the same period were selected as the healthy group.The levels of serum PCSK9,ATG7 and GDF15 were detected by using the enzyme-linked immunosorbent assay kit.The acute physiology and chronic health evaluationⅡ(APACHEⅡ)score was used to evaluate the condition of patients with AP.Multivariate Logistic regression analysis was used to analyze the factors influencing the poor prognosis of AP patients.The receiver operating characteristic(ROC)curve was drawn to analyze the predictive value of serum PCSK9,ATG7 and GDF15 levels for the prognosis of patients with AP.Results The levels of serum PCSK9,ATG7 and GDF15 in the disease group were higher than those in the healthy group,and the difference was statistically significant(P<0.05).Compared with the APACHEⅡscores of patients with low levels of serum PCSK9,ATG7 and GDF15,the APACHEⅡscores of patients with high levels of serum PCSK9,ATG7 and GDF15 were higher,and the difference was statistically significant(P<0.05).The white blood cell count,APACHEⅡscore,serum PCSK9,ATG7 and GDF15 levels in the poor prognosis group were all greater than or higher than those in the good prognosis group,and the differences were statistically significant(P<0.05).The results of multivariate Logistic regression analysis showed that APACHEⅡscore,serum PCSK9,ATG7,and GDF15 levels were the influencing factors for poor progno-sis in AP patients(P<0.05).The results of ROC curve analysis showed that the area under the curve of the combined prediction of serum PCSK9,ATG7,and GDF15 levels for the prognosis of AP patients was better than that of the individual prediction(Z_(three combined-PCSK9)=5.125,Z_(Three combined-ATG7)=4.845,Z_(three combined-GDF15)=4.534,P<0.001).Conclusion The levels of serum PCSK9,ATG7 and GDF15 in patients with AP increase.The combination of the three has a high clinical value in predicting the prognosis of patients with AP.
作者
平雪蕾
艾庆巍
张志忠
PING Xuelei;AI Qingwei;ZHANG Zhizhong(Department of Emergency,Beijing Friendship Hospital Affiliated to Capital Medical University,Beijing 100050,China;Department of Emergency Medicine,Beijing Friendship Hospital Affiliated to Capital Medical University,Beijing 100050,China)
出处
《国际检验医学杂志》
2025年第24期3036-3040,3047,共6页
International Journal of Laboratory Medicine
