血清铁调素在急性胰腺炎患者中的临床意义

目的分析血清铁调素（HEP）在急性胰腺炎（AP）患者中的浓度变化和临床意义。方法于入院时、入院后第1、3、7天用酶联免疫分析法检测104例轻症急性胰腺炎（MAP）、45例重症急性胰腺炎（SAP）患者血清铁调素浓度，以门诊健康检查人群为对照组，比较各组铁调素浓度差异。结果AP患者入院时血清铁调素（115．88±1556）ng／ml高于对照组（5026±1392）ng／ml（P〈0．05）；入院后1、3、7天SAP组血清铁调素[（129．49±15．57）、（158．07±11．73）、（168．87±18．43）]ng／ml高于MAP组J（12458±12．60）、（142．62±15．09）、（13262±14．52）]ng／ml（P〈0．05），而入院时两组间血清铁调素浓度差异无统计学意义；铁调素与CRP、APACHE—II评分正相关，与血钙呈负相关。以入院后第3天血清铁调素、CRP绘制ROC曲线下面积分别为0．802、0782（P〉0．05）。结论AP患者血清铁调素浓度显著增高，血清铁调素可作为急性胰腺炎病情严重度判别的重要指标之一。

Objective To investigate the changes and clinical significance of serum hepcidin in patients with acute pancreatitis. Methods Blood samples from 104 patients with mild acute pancreatitis, 45 patients with severe acute pancretits and 50 healthy controls were measured by enzyme linked immunosorbent assay at admission on 1, 3, and 7 day. The clinical association of serum hepcidin level with acute pancreatitis was analyzed. Receiver operating characteristic curve was set up. Results The median concentration of serum hepcidin in patients with acute pancreatitis was 115.88 ± 15.56ng/ml, which was significantly higher than that in the healthy controls （ 50.26 ± 13.92 ） ng/ml at admission. （ P〈0.05 ） . On 1, 3, and 7 day after admission, the median concentration of serum hepcidin in patients with severe acute pancreatitis were （ 129.49 ± 15.57, 158.07 ± 11.73, 168.87± 18.43 ） ng/ml, that in patients with mild acute pancreatitis were （ 124.58± 12.60, 142.62± 15.09, 132.62± 14.52 ） ng/ml, their differences were significant （ P〈0.05 ） , but not at admission. The results of correlation analysis showed that the level of the serum hepcidin was positively correlated with c-reactive protein levels and APACHE-II score, while it was negatively correlated with serum calcium level. The area under the ROC curve performed by the serum hepcidin and c-reactive protein from severe acute pancreatitis and mild acute pancreatitis from 3 day after admission were 0.802 and 0.782, their differences were not significant （P〈0.05） . Conclusion Serum hepcidin is correlated with the extent of pancreatitis. It can be used in monitoring the development of acute pancreatitis and may be a potential marker for early diagnosis of severe acute pancreatitis.