血清netrin-1水平与急性胰腺炎严重程度的相关性及其临床应用价值

Correlation between serum netrin-1 level and severity of acute pancreatitis and its clinical application value

目的探讨血清netrin-1水平与急性胰腺炎严重程度的相关性及其临床应用价值。方法选取107例急性胰腺炎患者,其中轻症急性胰腺炎(MAP)组68例、重症急性胰腺炎(SAP)组39例,选取健康体检者作为对照组40例。采用酶联免疫吸附试验检测血清netrin-1水平;采用Pearson相关性分析描述netrin-1与临床检测指标间的相关性;通过绘制ROC曲线分析netrin-1对SAP的诊断价值。结果急性生理和慢性健康状况评分Ⅱ(APACHEⅡ评分)、Ranson评分、C-反应蛋白(CRP)、尿淀粉酶(U-Amy)、尿胰蛋白酶原激活肽(TAP)、netrin-1在SAP组最高,其次是MAP组,对照组最低(P<0.05)。MAP组、SAP组的血淀粉酶(S-Amy)、胰脂肪酶(LPS)水平高于对照组(P<0.05),但是S-Amy、LPS水平在MAP组、SAP组间无显著性差异(P>0.05)。netrin-1与APACHE II评分、Ranson评分、CRP、TAP呈正相关(P<0.05),而与S-Amy、U-Amy、LPS无相关性(P>0.05)。当血清netrin-1水平>478.00μg/L时,对SAP的诊断敏感性为87.18%,特异性为83.82%,ROC曲线下面积为0.916(0.865~0.967),均高于APACHEⅡ评分、Ranson评分、CRP的ROC曲线下面积。结论血清netrin-1水平对急性胰腺炎严重程度的诊断价值优于APACHEⅡ评分、Ranson评分、C-反应蛋白(CRP)指标,具有较好的临床应用前景。

Objective To explore the correlation between serum netrin-1 level and severity of acute pancreatitis and its clinical application value.Methods A total of 107 patients with acute pancreatitis were selected,including 68 patients in the mild acute pancreatitis(MAP)group and 39 patients in the severe acute pancreatitis(SAP)group.40 healthy subjects were selected as the control group.Enzyme-linked immunosorbent assay was used to detect the serum level of netrin-1.Pearson correlation analysis was used to describe the correlation between netrin-1 and clinical indicators.The diagnostic value of netrin-1 for SAP was analyzed by ROC curve.Results Acute physiology and chronic health evaluation II(APACHE II score),Ranson score,C-reactive protein(CRP),urine amylase(U-Amy),trypsinpgen activation peptide(TAP),netrin-1 in the SAP group were the highest,followed by the MAP group and the lowest in the control group(P<0.05).The levels of serum amylase(S-Amy)and lipase(LPS)in the MAP and SAP groups were higher than those in the control group(P<0.05),but the levels of S-Amy and LPS were not significantly different between the MAP and SAP groups(P>0.05).The netrin-1 was positively correlated with APACHE II score,Ranson score,CRP,and TAP(P<0.05),but had no correlation with S-Amy,U-Amy,and LPS(P>0.05).When the serum level of netrin-1 was>478.00μg/L,the diagnostic sensitivity to SAP was 87.18%,the specificity was 83.82%,and the area under the ROC curve was 0.916(0.865-0.967),which were higher than APACHE II score,Ranson score and CRP.Conclusion Serum netrin-1 level is better than APACHE II score,Ranson score,and C-reactive protein(CRP)in diagnosing the severity of acute pancreatitis,and has a better clinical application prospect.