血清表皮生长因子、肝细胞生长因子与急性胰腺炎严重程度及预后的相关性

The correlation between serum epidermal growth factor, hepatocyte growth factor, and severity or prognosis of acute pancreatitis

目的 探讨血清表皮生长因子、肝细胞生长因子与急性胰腺炎严重程度及预后的相关性,为临床诊治提供依据.方法 选择急性胰腺炎（AP）患者112例,按严重程度分为轻症急性胰腺炎（MAP）组（n=66）和重症急性胰腺炎（SAP）组（n=46）,两组患者均采用常规治疗,观察两组患者血清表皮生长因子（EGF）、肝细胞生长因子（HGF）水平,并与急性生理和慢性健康状况评分表Ⅱ（APACHEⅡ）评分进行相关性分析,比较两组患者的并发症情况.结果 MAP组、SAP组血清EGF、HGF水平均明显高于对照组,SAP组明显高于MAP组（P ＜0.01）. MAP组、SAP组APACHE Ⅱ评分分别为（5.4±1.6）分、（9.0±2.9）分,APACHE Ⅱ评分与血清EGF、HGF水平呈正相关（P=0.00）.SAP组的（感染、脓肿、坏死）、急性肺损伤或ARDS发生率明显高于MAP组（P＜0.01）.结论 AP的严重程度及预后与患者血清HGF、EGF水平关系密切,在早期及时监测HGF、EGF的变化对评估病情及判断预后有一定的临床价值,由于HGF、EGF具有较强的组织修复与再生功能,这也可能为临床治疗提供一个新途径.

Objective To investigate the correlation between serum epidermal growth factor, hepatocyte growth factor and a- cute pancreatitis severity or prognosis, and to provide the basis for acute pancreatitis clinical diagnosis and treatment. Methods A total of 112 patients with acute pancreatitis （AP） were selected, and they were divided into mild acute pancreatitis （MAP） group （ n = 66） and severe acute pancreatitis （SAP）. group （ n = 46 ） according to severity. The patients in two groups were treated with conventional therapy. The levels of serum epidermal growth factor （EGF） and hepatocyte growth factor （HGF） in two groups were observed. The correlation analysis was performed with acute physiology and chronic health evaluation II （APACHE II） score. The complications of patients in two groups were compared. Results The levels of serum EGF and HGF in MAP group and SAP group were significantly higher than those in control group, while they in SAP group were significantly higher than those in MAP group （ P 〈0. 01 ）. The APACHE II scores of MAP and SAP groups were （5.4 ± 1.6）% and （9 ±2. 9）%, and the APACHE II score was positively related to serum EGF and HGF levels （ P = 0. 00）. The infection, abscess, necrosis, acute lung injury, or the incidence of ARDS in SAP Group were higher than that in MAP group （ P 〈 0.01 ）. Conclusions AP severity and prognosis were related to patient＇s serum HGF and EGF levels. Therefore, early and timely monitoring changes of HGF, EGF, and HGF had a certain clinical value to assess condition and prognosis, and EGF had a strong tissue repair and regeneration functions, which might provide a new way to clinical treatment.