sE-Cadherin早期评价急性胰腺炎严重程度的临床价值

The Clinical Significance of sE-Cadherin for Early Evaluation of the Severity of Acute Pancreatitis

目的探讨可溶性E-钙黏素(sE-Cadherin)对早期判断急性胰腺炎严重程度的临床价值。方法选择急性胰腺炎患者69例[轻度急性胰腺炎(MAP)30例、中度急性胰腺炎(MSAP)23例、重度急性胰腺炎(SAP)16例],其他急腹症20例,健康个体20例。采用双抗体夹心ELISA法分别检测腹痛开始12、24、48 h血浆sE-Cadherin值,评价与胰腺炎严重程度关联性的敏感度和特异度,并分析与临床检测指标的相关性。结果血浆sE-Cadherin值在发病12、24、48 h均呈阳性,但MAP组、健康组、其他急腹症组相互之间无统计学差异(P>0.05);MSAP组、SAP组血浆sE-Cadherin值分别较其他3组明显升高(P<0.001),且SAP组高于MSAP组,差异有统计学意义(P<0.001)。sE-Cadherin对判断中度以上胰腺炎敏感度92.3%,特异度90%,判断SAP敏感度81.3%,特异度98.1%。sE-Cadherin与乳酸脱氢酶、高敏C反应蛋白、血糖、白细胞呈线性正相关,与白蛋白呈线性负相关(P均<0.05)。结论 sE-Cadherin对早期判断急性胰腺炎严重程度具有重要的临床价值,同时有很高的敏感度、特异度,与临床判断严重程度指标呈线性相关。

Objective To explore the clinical value of sE-Cadherin for early judgment of the severity of acute pancreatitis. Methods 69 cases of acute pancreatitis patients （ MAP. 30, MSAP ： 23, SAP ： 16）, 20 patients with other acute abdominal pain, and 20 cases of healthy individuals were enrolled for the study. Double antibody sandwich ELISA method was used to measttre plasma sE-Cadherin at 12 h, 24 h and 48 h after onset of ab- dominal pain. The correlation among sE-Cadherin expression, clinical detection index and severity degree of sensitivity and was evaluated in acute pancreatitis patients. Results No statistical difference of plasma sE-Cadherin was found between each other among the MAP group, healthy group and other acute abdominal disease group at 12, 24 and 48 hours （P 〉 0.05） ; MSAP and SAP group was higher than any of the first three groups （P 〈 0.001 ） ; SAP group was significantly higher than MSAP group （P 〈 0.001 ）. By the cutoff of sE-Cadherin, the sensitivity and specificity to judge above moderate pancreatitis were 92.3% and 90%, which were 81.3% and 98.1% for SAP evaluation, sE- Cadherin is positively correlated with LDH, hs-CRP, GLU, WBC and negatively correlated with ALB （P 〈 0.05 ）. Conclusion sE-Cadherin has important clinical value in evaluation of the severity of acute pancreatitis at early time. Meanwhile, sE-Cadherin shows a high sensitivity and specificity, which is correlated with the clinical severity index.