早期低维生素C水平对急性胰腺炎病人免疫功能和临床预后的影响

The effects of low serum Vitamin C levels in early stage on immune function and clinical outcomes in acute pancreatitis patients

目的:本研究旨在探究早期低维生素C水平对急性胰腺炎(AP)病人免疫功能和临床预后的影响。方法:前瞻性观察性研究,纳入2018年1月~2019年6月入住我院的胰腺炎病人的临床数据,经过纳排标准后,最终有34例病人纳入正常维生素C水平组,30例病人纳入低维生素C水平组。统计并分析病人的一般临床资料、主要免疫指标、炎症指标以及临床预后。结果:在基线数据方面,两组之间没有显著差异,但低维生素C水平组病人疾病严重程度更高;血清学指标中,相比于正常组,低维生素C水平组病人血清炎症介质IL-6水平更高,免疫指标IgA,IgG,CD4+T细胞比例,CD4+/CD8+比值等均显著较低;在临床预后方面,低维生素C水平组的AP病人器官功能障碍和胰腺坏死发生比例更高;Logistic回归分析显示低维生素C水平是重型急性胰腺炎(SAP)发生的重要独立危险因素。结论:低维生素C水平与AP病人的免疫功能受损以及不良临床预后密切相关,是预测SAP发生的重要因素之一。

Objective:The aim of this study was to investigate the effects of low serum vitamin C levels in early stage on immune function and clinical outcomes in patients with acute pancreatitis(AP).Methods:A prospective observational study of AP patients admitted to our hospital from January 2018 to June 2019 was performed.After inclusion and exclusion,thirty-four patients were eventually enrolled in the control group and 30 patients in the low vitamin C group(study group).The demographic characteristics,serum immune parameters as well as clinical outcomes of included patients were recorded and analyzed.Results:In terms of baseline data,the disease severity of AP in the study group was severer and more patients suffered from severe form of acute pancteatitis(SAP).In immune function associated parameters,the serum IgA,IgG levels,CD4+T percentage,as well as CD4+/CD8+ratio were significantly lower in the study group compared with the control group.As to in-hospital clinical outcomes,patients in the study group had higher incidence of organ failure and pancreatic necrosis than that in the control group.The further logistic regression analysis showed that low serum vitamin C level was an independent and significant risk factor for the occurrence of SAP.Conclusion:Low serum vitamin C level was strongly associated with immune dysfunction and poor clinical outcomes in AP patients,which could function as a significant predictive factor for SAP.