血清TREM-1和CA-125对早期急性胰腺炎严重程度的评估价值

Evaluation of serum TREM-1 and CA-125 levels in the severity of early acute pancreatitis

目的探讨髓样细胞触发受体-1(TREM-1)和血清糖链抗原-125(CA-125)在急性胰腺炎(AP)严重程度早期评估中的应用价值。方法回顾分析2015年9月至2016年9月在安庆市立医院就诊的35例轻型胰腺炎(MAP组)和22例重型胰腺炎(SAP组)患者发病早期血清中TREM-1和CA-125的表达情况,并以同时期在院内体检的30名健康体检者作为对照组,分析TREM-1和CA-125的表达变化;以临床诊断结果作为金标准,评估早期TREM-1、CA-125变化对预测SAP的诊断价值。结果入院第1天,MAP组、SAP组患者血清TREM-1、CA-125表达水平均高于正常对照组,差异均有统计学意义(P均<0.05);SAP组患者入院第1天、第3天、第5天及第7天血清TREM-1、CA-125的表达水平均高于MAP组,差异均有统计学意义(P均<0.05)。入院24小时内,TREM-1和CA-125检测诊断SAP的敏感度分别为81.82%和77.27%,特异度为90.77%和72.31%,准确度为88.51%和73.56%;TREM-1检测的特异度和准确度均高于CA-125,差异均有统计学意义(P均<0.05)。结论血清TREM-1和CA-125均可反映AP的严重程度,但TREM-1检测在早期SAP评估中的诊断价值优于CA-125。

Objective To discuss the application value of serum triggering receptor expressed on myeloid cell - 1 （TREM - 1） and carbohydrate antigen - 125 （CA -125） in the early severity assessment of acute pancreatitis （AP）. Methods The serum expression of TREM - 1 and CA - 125 in 35 patients with mild pancreatitis （ MAP group） and 22 patients with severe pancreatitis （SAP group） in the early stage, ever treated in our hospital from Sep 2015 to Sep 2016, were retrospectively analyzed. Other 30 healthy subjects underwent physical examination were simultaneously enrolled as the control group, and expression changes of TREM - 1 and CA - 125 between those AP patients and healthy controls were analyzed. Using the clinical diagnosis as gold standard, the diagnostic value of early changes of TREM - 1 and CA125 in the SAP prediction was evaluated. Results At the first day after admission, the serum expression levels of TREM - 1 and CA - 125 in the MAP and SAP groups were significantly higher than those in the control group （P 〈0. 05）. The expression levels of TREM - 1 and CA - 125 in the SAP group at the 1st, 3rd, 5th and 7th day after admission were all significantly higher than those in the MAP group （all P 〈0. 05）. Within 24 hours after admission, the sensitivity and specificity of TREM - 1 and CA - 125 in diagnosis of SAP was 81. 82% and 77.27%, 90.77% and 72.31%, respectively, and the accuracy of TREM - 1 and CA - 125 was 88. 51 % and 73.56%. The specificity and accuracy of TREM - 1 were all significantly higher than those of CA - 125 （ P 〈 0. 05 ）. Conclusion Both of the serum levels of TREM - 1 and CA - 125 could be used to reflect the severity of AP, but the diagnostic value of TREM - 1 in early evaluation of SAP patients is better than that of CA - 125.