血清巨噬细胞炎性蛋白-1α、巨噬细胞炎性蛋白-1β和单核细胞趋化因子蛋白-1在重症胆源性梗阻型胰腺炎中的表达及临床意义

The expression and clinical significance of serum MIP-1α,MIP-1βand MCP-1 in severe biliary obstructive pancreatitis

目的探究血清巨噬细胞炎性蛋白-1α(MIP-1α)、巨噬细胞炎性蛋白-1β(MIP-1β)及单核细胞趋化因子蛋白-1(MCP-1)在重症胆源性梗阻型胰腺炎中的表达及临床意义。方法选择2012年8月至2018年10月我院收治的110例胆源性梗阻型胰腺炎患者,根据患者临床症状及检查结果分为轻症组50例和重症组60例;另择同期于我院查体的50例健康体检者作为对照组。测定受试者入第1、3、7天时血清MIP-1α、MIP-1β和MCP-1水平,进行急性生理及慢性健康状况II(APACHEII)评分及重症组预后随访。结果①轻症组及重症组患者入院第1天血清MIP-1α、MIP-1β和MCP-1指标水平及APACHEII评分均显著高于对照组(P<0.05);重症组患者各指标显著高于轻症组(P<0.05);Pearson相关性分析示,血清MIP-1α、MIP-1β和MCP-1与APACHEII评分呈正相关(P<0.05)。②与入院第1天比较,轻症组及重症组患者入院后第3、7d患者MIP-1α、MIP-1β和MCP-1等血清学指标均显著降低,各组不同时间点比较差异有统计学意义(P<0.05)。③血清MIP-1α、MIP-1β和MCP-1诊断重症胆源性梗阻型胰腺炎的ROC曲线下面积为0.803、0.857、0.797;截点值为687.2、56.4、60.4 ng/L。④重症梗阻性胰腺炎死亡组患者血清MIP-1α、MIP-1β和MCP-1水平显著高于存活组患者(P<0.05)。结论胆源性梗阻型胰腺炎患者可伴有血清MIP-1α、MIP-1β和MCP-1水平的升高,其升高幅度与病情严重程度相关,可作为早期诊断病情、指导治疗的参考指标。

Objective To investigate the expression and clinical significance of serum macrophage inflammatory protein-1α(MIP-1α),macrophage inflammatory protein-1β(MIP-1β)and monocyte chemoattractant protein-1(MCP-1)in severe biliary obstructive pancreatitis.Methods One hundred and ten patients with biliary obstructive pancreatitis admitted to our hospital from August2012 to October 2018 were selected.According to the clinical symptoms and examination results,the patients were divided into mild group(n=50)and severe group(n=60).At the same time,50 healthy subjects who were examined in the hospital were selected as the control group.Serum levels of MIP-1α,MIP-1βand MCP-1 were measured at the 1,3 and 7 day of admission and acute physiology and chronic health status II(APACHE II)were used for scoring.The severe group was followed.Results Serum levels of MIP-1α,MIP-1βand MCP-1 and APACHE II scores on the 1 stday of the mild and severe group were significantly higher than those of the control group(P<0.05).The indicators in the severe group were significantly higher than those in the mild group(P<0.05).Pearson correlation analysis showed that serum MIP-1α,MIP-1βand MCP-1 were positively correlated with APACHE II score(P<0.05).Compared with the 1 stday of admission,the indexes of MIP-1α,MIP-1βand MCP-1 in the mild and severe patients on the 3 rdand 7 thdays were significantly decreased(P<0.05).The areas under the ROC curves of serum MIP-1α,MIP-1βand MCP-1 for diagnosis of severe biliary obstructive pancreatitis were 0.803,0.857 and 0.797,respectively and the cut-off values were 687.2 ng/L,56.4 ng/L and 60.4 ng/L,respectively.The levels of serum MIP-1α,MIP-1βand MCP-1 in the death group were significantly higher than those in the survival group(P<0.05).Conclusion Patients with biliary obstructive pancreatitis have elevated levels of serum MIP-1α,MIP-1βand MCP-1,and the increase is related to the severity of the disease.They can be used as reference indicators for early diagnosis and treatment.