可溶性B7-H3在早期预测急性胰腺炎严重程度中的临床意义

Clinical significance of soluble B7- H3 in early evaluating the severity of patients with acute pancreatitis

目的:探讨s B7-H3(可溶性B7-H3)对早期判断急性胰腺炎(AP)严重程度的临床价值。方法:选择AP患者75例(轻度MAP 30例、中度MSAP 20例、重度SAP 25例),对照组为健康(HC)组20例,采用双抗体夹心ELISA法测腹痛开始24 h血浆s B7-H3值,评价与胰腺炎严重程度关联性的敏感度和特异度,及与临床检测指标相关性分析。结果:腹痛24 h血浆s B7-H3值,AP组显著高于对照组(t=3.925,P=0.0002),MAP组与HC相相比差异没有显著性,MSAP组和SAP组均显著高于HC组(P<0.05和P<0.01)和MAP组(P<0.05和P<0.01);SAP组显著高于MSAP组(P<0.01)。s B7-H3与LDH、hs-CRP、WBC呈线性正相关,与ALB、Ca(S)呈线性负相关(均P<0.05);s B7-H3对判断中度以上胰腺炎敏感度为88.9%,特异度为83.3%,判断SAP的敏感度为96%,特异度96%。结论:s B7-H3对急性胰腺炎严重程度早期判断有重要临床价值,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 investigate the clinical value of sB7-H3 in predicting the severity of acute pancreatitis at early stage. Methods By using the double antibody sandwich ELISA method, the level of plasma sBT-H3 was measured at 24h after onset of abdominal pain in 75 patients with acute pancreatitis （MAP30, MSAP20, SAP25）, and 20 healthy persons were enrolled in the controlgroup.The sensitivity and specificity correlations of sBT-H3 in acute pancreatitis with severity degree, as well as with the clinical detection index, were also evaluated. Results The level of plasma sB7-H3 at 24 h in the AP group was significantly higher than that in the healthy control（HC） group （t = 3.925, P = 0.0002）, however, no significant difference was found between the MAP groep and the HC group （P 〉 0.05）. The levels of plasma sB7-H3 in the MSAP and the SAP group were significantly higher than that in the HC group （P 〈 0.05 和 P 〈 0.001 ）or the MAP group （P 〈 0.05 和 P 〈 0.01 ） ; The level of plasma sBT-H3 in the SAP group was also markedly higher than that in the MSAP group （P 〈 0.01 ）. sB7-H3 had a linear positive correlation with LDH, hs-CRP, WBC （P 〈 0.05 ）. ALB had a linear negative correlation with and Ca （S） （P 〈 0.05）. By the cutoff of sB7-H3, the sensitivity and specificity to judgethe above moderate pancreatitis were 88.9% and 83.3%,and to judgethe SAP were 96% and 96%. Conclusion sBT-H3 has important clinical value to judge the severity of acute pancreatitis at early time with high sensitivity and specificity, with a linear correlation with the clinical severity index.