胱抑素C在急性胰腺炎并发全身炎症反应综合征致多器官功能障碍综合征患者中的变化

Cystatin-C level in acute pancreatitis leading to systemic inflammatory response syndrome resulted multiple organ dysfunction syndrome patients

目的观察胱抑素C(cystatin-C,Cys-C)在急性胰腺炎(acute pancreatitis,AP)并发全身炎症反应综合征(systemic inflammatory response syndrome,SIRS)致多器官功能障碍综合征(multiple organ dysfunction syndrome,MODS)患者中的变化。方法 AP患者178例,根据其并发SIRS、MODS情况分为3组:AP组127例、SIRS组30例、MODS组21例。同时,收集健康体检者30例作为正常对照组。测定所有待测者血清Cys-C、降钙素原(procalcitonin,PCT)、超敏C反应蛋白(hypersensitive C-reactive protein,hs-CRP)水平,观察Cys-C水平与AP并发SIRS、MODS情况,以及其与血清hs-CRP、PCT水平的相关性。结果与对照组比较,观察组血清Cys-C、PCT、hs-CRP水平均明显升高(P<0.01)。与AP组比较,SIRS、MODS组升高更为明显,以MODS组更为突出(P<0.05或P<0.01)。相关性分析表明,血清Cys-C水平与PCT、hs-CRP呈正相关。结论Cys-C与炎症反应关系密切,参与了AP并发SIRS、MODS,并具有重要作用。

Objective To observe the change of cystatin-C （Cys-C）in acute pancreatitis （AP）leading to systemic inflammatory response syndrome （SIRS）which causes multiple organ dysfunction syndrome （MODS）. Methods A total of 1 78 AP cases were divided into three groups：simple AP （AP group）127 cases,AP accompanied with SIRS （SIRS group）30 cases,AP accompanied with MODS （MODS group）21 cases.Thirty healthy subjects from body check served as normal control group.The levels of serum Cys-C,procalcitonin （PCT）,hypersensitive C-reactive protein （hs-CRP）were detected in all participants.Analysis was made in the correlation between the serum Cys-C levels and the incidence of AP accompanied with SIRS,MODS.The correlation was explored in serum Cys-C level and PCT,hs-CRP level.Results The serum Cys-C,hs-CRP and PCT levels in patients with AP,SIRS and MODS increased significantly compared with those in normal control group （P 〈0.01）.The serum Cys-C,PCT and hs-CRP levels in patients with MODS were significantly higher than those in patients with AP,SIRS （P 〈0.05 or P 〈0.01）.The serum Cys-C level positively correlated with serum PCT and hs-CRP levels.Conclusion Cys-C closely related to inflammation,and it might play significant role in AP leading to SIRS which causes MODS.