急性胰腺炎患者外周血NGAL和胃饥饿素水平变化及其意义

Alterations in peripheral blood levels of NGAL and ghrelin in patients with acute pancreatitis and their significance

目的:探讨中性粒细胞明胶酶相关脂质运载蛋白(NGAL)及胃饥饿素(ghrelin)在急性胰腺炎(AP)患者外周血中水平高低与患者病情的关系。方法:收集既往收治的199例AP患者资料,其中急性轻症胰腺炎(MAP)103例,急性重症胰腺炎(SAP)96例;治疗期间17例(8.54%)死亡,分别比较不同病情与不同治疗转归及患者间入院第1天NGAL、ghrelin水平和其他指标的差异。结果:SAP患者的NGAL、ghrelin、C反应蛋白(CRP)、白细胞(WBC)、血淀粉酶、降钙素原(PCT)、APACHE II评分、Balthazar CT评分、BISAP指数均明显高于MAP组患者(均P<0.05);治疗期间死亡患者的以上指标也均明显高于存活患者(均P<0.05);199例患者外周血中NGAL、ghrelin水平与BISAP指数呈明显正相关关系(r=0.579、0.482,均P<0.05),且两者与BISAP指数的相关性优于血淀粉酶、WBC、PCT。结论:AP患者外周血中NGAL、ghrelin水平与病情密切相关,两者水平增高预示着患者预后的不良的风险增大。

Objective： To investigate the relations of levels of neutrophil gelatinase associated lipid lipocalin （NGAL） and ghrelin in peripheral blood of patients with the severity of illness of patients with acute pancreatitis （AP）. Methods. The clinical data of 199 AP patients treated previously were collected. Of the patients, 103 cases had mild AP （MAP） and 96 cases had severe AP （SAP）; 17 cases （8.54%） died during admission. The differences in NGAL and ghrelin levels and other parameters on the first day of admission were compared between patients with different severity of disease and different outcomes, respectively. Results： In patients with SAP, the levels of NGAL, ghrelin, C-reactive protein （CRP）, white blood cells （WBC）, serum amylase, procalcitonin （PCT）, and APACHE II score, Balthazar CT score and BISAP index were significantly increased compared with patients with MAP （all P〈0.05）; in patients who died during treatment, all the above-mentioned parameters were also significantly higher than those in patients who were cured （all P〈0.05）. In the 199 patients, the peripheral blood levels of both NGAL and ghrelin had significant correlation with BISAP index （r=0.579 and 0.482, both P〈0.05）, and their correlation were superior to those of serum amylase, WBC and PCT with BISAP index. Conclusion： q-he peripheral blood levels of NGAL and ghrelin in AP patients are closely related to the severity of illness of the patients, and their increase may indicate increased risk of poor prognosis of patients.