摘要
目的探讨可溶性T细胞免疫球蛋白黏蛋白分子-3(sTIM-3)、半乳凝素-9(Gal-9)在早期急性胰腺炎(AP)患者血清中的表达及其意义,为AP的早期预测、诊断提供理论和临床依据。方法选择2020年9月15日至2021年7月23日南京医科大学附属常州第二人民医院收治的起病至入院时间≤48 h的AP患者94例,其中轻症急性胰腺炎(MAP)42例,中度重症急性胰腺炎(MSAP)35例,重症急性胰腺炎(SAP)17例。收集AP患者基本临床特征,所有AP患者均行急性生理学和慢性健康状况评价Ⅱ(APACHEⅡ)、改良计算机断层扫描严重指数(MCTSI)和急性胰腺炎严重程度床边指数(BISAP)评分。采用酶联免疫吸附试验检测血清白细胞介素(IL)-6、IL-10、sTIM-3、Gal-9水平。采用Kruskal-Wallis检验和Mann-Whitney U检验进行统计学分析。采用Spearman和Pearson相关分析研究患者sTIM-3、Gal-9与炎症指标和AP相关评分系统的相关性,应用受试者操作特征曲线(ROC)分析sTIM-3联合Gal-9对预测AP患者疾病严重程度的效能。结果SAP患者的血清sTIM-3、Gal-9、IL-6水平均高于MAP患者[2085.00 ng/L(1628.00 ng/L,2673.00 ng/L)比746.10 ng/L(514.50 ng/L,1303.00 ng/L)、466.60 ng/L(375.90 ng/L,629.30 ng/L)比108.10 ng/L(90.29 ng/L,138.90 ng/L)、(323.60±62.93)ng/L比(42.90±28.82)ng/L],而IL-10水平低于MAP患者[(760.30±200.40)ng/L比(1206.00±566.30)ng/L],差异均有统计学意义(Z=45.00、<0.01,t=23.62、3.15;均P<0.01)。SAP患者的APACHEⅡ和BISAP评分均高于MAP、MSAP患者[12.00分(6.00分,16.50分)比3.00分(2.00分,5.00分)、6.00分(3.00分,8.00分)和3.00分(3.00分,4.00分)比1.00分(1.00分,1.00分)、2.00分(2.00分,3.00分)],MCTSI评分高于MAP患者[4.00分(3.00分,6.00分)比2.00分(0.00分,2.00分)],差异均有统计学意义(Z=644.50、704.00、474.50、492.50、664.00,均P<0.001)。血清sTIM-3、Gal-9与促炎因子IL-6均呈正相关(r=0.552、0.297,P<0.001、=0.004),而血清sTIM-3与抗炎因子IL-10呈负相关(r=-0.397,P<0.001),
Objective To investigate the expression and significance of serum soluble T cell immunoglobulin-domain and mucin-domain protein-3(sTIM-3)and galectin-9(Gal-9)in patients with early acute pancreatitis(AP),so as to provide theoretical and clinical evidence for the early prediction and diagnosis of AP.Methods From 15 September 2020 to 23 July 2021,a total of 94 AP patients with a time from onset to admission≤48 h who were admitted to Changzhou No.2 People′s Hospital,Nanjing Medical University were selected,including 42 cases of mild acute pancreatitis(MAP),35 cases of moderately severe acute pancreatitis(MSAP)and 17 cases of severe acute pancreatitis(SAP).The basic clinical features of AP patients were collected.Acute physiology and chronic health evaluationⅡ(APACHEⅡ),modified computed tomography severity index(MCTSI)and bedside index for severity in acute pancreatitis(BISAP)scores were evaluated in all AP patients.The levels of serum interleukin(IL)-6,IL-10,Gal-9 and sTIM-3 were detected with enzyme linked immunosorbent assay.Kruskal-Wallis test and Mann-Whitney U test were used for statistical analysis.Spearman rank correlation test and Pearson correlation analysis were used to analyze the correlation of sTIM-3,Gal-9 with inflammatory indicators and AP related scoring systems.Receiver operating characteristic curve(ROC)was performed for efficiency analysis of the combination of sTIM-3 and Gal-9 in predicting the severity of AP patients.Results Serum sTIM-3,Gal-9 and IL-6 levels of SAP patients were higher than those of MAP patients(2085.00 ng/L(1628.00 ng/L,2673.00 ng/L)vs.746.10 ng/L(514.50 ng/L,1303.00 ng/L);466.60 ng/L(375.90 ng/L,629.30 ng/L)vs.108.10 ng/L(90.29 ng/L,138.90 ng/L);(323.60±62.93)ng/L vs.(42.90±28.82)ng/L),while IL-10 level was lower than that of MAP patients((760.30±200.40)ng/L vs.(1206.00±566.30)ng/L),and the differences were statistically significant(Z=45.00 and<0.01,t=23.62 and 3.15;all P<0.01).The APACHEⅡand BISAP scores of SAP patients were higher than those of MAP and MSAP pa
作者
王辅双
孟瑶
林媛
李荣男
林敏
Wang Fushuang;Meng Yao;Lin Yuan;Li Rongnan;Lin Min(Department of Gastroenterology,Changzhou No.2 People′s Hospital,Nanjing Medical University,Changzhou213000,China;Graduate School,Dalian Medical University,Dalian 116000,China;Department of Gastroenterology,Changzhou Hospital of Traditional Chinese Medicine,Nanjing University of Chinese Medicine,Changzhou 213000,China)
出处
《中华消化杂志》
CAS
CSCD
北大核心
2022年第6期383-388,共6页
Chinese Journal of Digestion
基金
江苏省博士后科研资助项目(2019K065)
常州市卫生健康委员会青年人才科技项目(QN201927)。
