急性胰腺炎血清细胞间黏附分子1表达的临床意义

Expression of serum intercellular adhension molecule-1 in acute pancreatitis

目的 探讨血清可溶性细胞间黏附分子 1(ICAM 1)表达与急性胰腺炎 (AP)的关系及检测血清ICAM 1对重症急性胰腺炎的诊断价值。方法 采用双抗夹心ABC 酶联免疫吸附测定法对 76例急性胰腺炎检测外周静脉血ICAM 1,观察入院后 1、4、7、14天ICAM 1的动态变化及其表达与急性胰腺炎病情严重度及预后的关系 ;并探讨用检测血清ICAM 1的实验方法对重症急性胰腺炎的诊断价值。结果 急性胰腺炎除轻症患者第 14天外 ,ICAM 1检测值明显高于健康献血组 ,(P <0 .0 5、P <0 .0 1) ;轻症急性胰腺炎ICAM I呈逐渐下降曲线 ,峰值在入院后第 1天 ,急性重症胰腺炎呈上升趋势曲线 ,峰值在入院后第 4天 ,各时段两组比较差异均有统计学意义 (P <0 .0 5、P <0 .0 1) ;检测ICAM 1诊断重症急性胰腺炎的敏感度为 76 .19% ,特异度为 85 .4 5 % ,准确度为 82 .89% ,阳性似然比为 5 .2 3,阴性似然比为 0 .2 7,死亡病例血清ICAM I表达明显高于存活病例 ,检测值 >正常上限 11倍。结论 急性胰腺炎血清黏附分子ICAM 1有较高表达 ,并与病情严重度及预后密切相关 ,可通过检测血清ICAM

Objective To discuss the relationship between intercellular adhesion molecule-1(ICAM-1) expression and acute pancreatitis(AP) and to value the examination of serum ICAM-1 in severe AP diagnosis.Methods ICAM-1 in blood samples from 76 cases of AP were measured dynamically in 1st,4th,7th and 14th day after admission by ABC-enzyme-linked immunosorbent assay and the relationship between the expression of ICAM-1 and the severity and prognosis of AP were observed. The importance of examing ICAM-1 to severe AP diagnosis was valued.Results The ICAM-1 values in observing group were significantly higher than those in the health control except in the 14th day of mild AP patients(P< 0.05,P< 0.01).The highest of ICAM-I in mild AP was in the first day after admission and then decreased gradually.On the contrary,the ICAM-I in severe AP increased from admission and reached the peak in the 4th day.There were significant differences between the two groups at any time.The sensitivity of severe AP was 76.19%,specificity 85.45%,accuracy 82.89%,positive likelihood ratio was 5.23,negative likelihood ratio was 0.27.ICAM-1 in the death cases was significantly higher than that in the survival ones,the former′s ICAM-1 was 11 times higher than that of normal value.Conclusion ICAM-1 has a rather high expression in AP and has a close relationship with the severity and prognosis of AP.Severe AP can be filtrated by the examination of ICAM-1 accurately.