信号转导和转录激活子1的活化抑制蛋白对急性胰腺炎的预后判断

Severity and prognostic prediction of protein inhibitor of activated STAT 1 on acute pancreatitis

目的检测信号转导和转录激活子1的活化抑制蛋白（PIASl）在急性胰腺炎（AP）大鼠胰腺中的表达，探讨其对AP病情的评估价值。方法SD大鼠按随机分配表法分为对照组、急性水肿性胰腺炎（AEP）组、急性坏死性胰腺炎（ANP）组，各15只。术后0．5、6、16、24、48、72h分批处死大鼠，取血清检测c反应蛋白（CRP）、淀粉酶水平，测胰腺组织含水量，行胰腺常规病理检查并评分，采用蛋白质印迹法和免疫组化法检测胰腺组织PIASI表达。记录大鼠72h生存情况，行Cox多因素风险评估。结果ANP组16h时的胰腺病理评分、胰腺含水量、血清CRP和淀粉酶水平分别为（7．70±2．55）分、（2．91±0．57）％、（0．36±0．05）mg／L、（3141±625）U／L，均显著高于AEP组的（2，604-1．04）分、（2．044-0．47）％、（0．24±0．05）mg／L、（1984±637）U／L，亦显著高于对照组的（0．80±0．42）分、（1．21±0．27）％、（0．14±0．03）mg／L、（978±353）U／L（P值〈0．05或〈0．01）。ANP组大鼠平均生存时间为（26．4±3．4）h，较AEP组的（57．3±4．2）h和对照组的（71．3±0．5）h显著缩短（尸值均〈0．01）。ANP组16h时的胰腺组织PIASl蛋白表达较AEP组及对照组显著下调（0．10±0．01Lt0．80±0．07和0．87±0．05，P〈0．01）。Cox分析显示PIASl为影响AP大鼠生存时间的独立因素之一。结论PIASl在ANP中低表达，与AP病情严重度呈负相关，可以成为预测病情严重程度及预后的指标。

Objective To investigate the expression of protein inhibitor of activated STAT-1 （PIAS1） in rat with acute pancreatitis （AP） and study its prediction value for severity and prognosis. Methods SD rats were randomly divided into control, acute edematous pancreatitis （ AEP）, and acute necrotizing pancreatitis （ANP） groups with 15 rats in each group. The rats were sacrificed at 0.5, 6, 16, 24, 48, 72 h post- operatively. Serum CRP and amylase levels were determined. Water content of pancreas was measured. The pancreatic tissue was routinely harvested and underwent pathologic examination and was scored. The PIAS1 protein expression was measured by Western blot and immunohistochemistry method. The survival rates at 72h were recorded and the risk analysis of multiple factors was investigated by Cox regression method. Results The pathologic score, Water content of pancreas, serum CRP and amylase levels at 16h in ANP group were （7.70 ±2.55 ）, （ 2.91 ±0.57 ） %, （0.36± 0.05 ） mg/L, （ 3141± 625 ） U/L, which were significantly higher than those in AEP group [ （2.60 ±1.04）, （2.04±0.47）%, （0.24 ±0.05）mg/L, （1984 ± 637）U/L） ], and also significantly higher than those in control group [ （0.80±0.42 ）, （ 1.21± 0.27 ） %, （0.14 ± 0.03 ） mg/L, （978 ± 353 ） U/L, （ P 〈 0.05 or 0.01 ） ]. The survival time of ANP rats was [ （ 26.36 ＋ 3.41 ） h, 95% CI： 19.67 -33.06 hi, whieh were significantly shorter than that in AEP group [ （57.26±4.16）h, 95% CI： 49.11 -65.42） ], and also significantly shorter than that in eontrol group [ （71.33±0.54） h,95% CI：70.26 - 71.40, P 〈 0.01 ]. The expression of PIAS1 at 16h in ANP group was significantly lower than those in AEP group and control group （0.10 ±0. Olvs. O. 80 ± 0.07, O. 87 ± 0.05 ,P 〈 0.01 ）. The Cox analysis suggested that PIAS1 was an independent prognosis factor for the survival time of AP rats. Conclusions PIAS1 is lowly to moderately expressed in ANP, and is negatively correlated with AP severity, and may be an independent risk faetor for the prediction of severity and prognosis of AP.