重症急性胰腺炎患者血浆RUNX3、IL-17表达与疾病进展相关性分析

Analysis of the correlations between the expressions of RUNX3 and IL-17 in plasma and the progression of severe acute pancreatitis

目的观察重症急性胰腺炎(SAP)患者血浆人RUNT相关转录因子3(RUNX3)、白细胞介素-17(IL-17)表达水平,并分析其与疾病进展的相关性。方法选取ICU收治的SAP患者80例作为观察组,根据APACHEⅡ评分高低进一步分为两组:评分<20分组(n=37),评分>20分组(n=43);另选取同期健康体检者80例作为对照组。详细记录患者一般资料并进行比较。采用酶联免疫吸附法(ELISA)测定血浆RUNX3蛋白及IL-17水平;采用Pearson法分析血浆RUNX3蛋白、IL-17表达水平与APACHEⅡ评分相关性;二元logistic回归分析SAP发生的影响因素;受试者工作特征(ROC)曲线分析血浆RUNX3蛋白、IL-17及两者联合对SAP的诊断价值。结果与对照组比较,观察组患者血浆RUNX3蛋白水平显著降低(P<0.05),IL-17水平显著升高(P<0.05);与评分<20分组比较,评分>20分组患者血浆RUNX3蛋白表达水平显著降低(P<0.05),IL-17水平显著升高(P<0.05)。Pearson相关分析显示,血浆RUNX3蛋白水平与APACHEⅡ评分呈负相关(P<0.05),血浆IL-17水平与APACHEⅡ评分呈正相关(P<0.05)。二元logistic回归分析结果显示,血浆RUNX3蛋白低表达、IL-17高表达是SAP危险因素(P<0.05)。ROC曲线显示,血浆RUNX3蛋白、IL-17水平预测SAP的ROC曲线下面积(AUC)分别为0.874、0.879,敏感度分别为89.5%、81.3%,特异度分别为83.6%、76.6%;两者联合检测预测SAP的AUC为0.951,敏感度和特异度分别为92.5%、83.7%。结论血浆RUNX3蛋白低表达、IL-17高表达是SAP危险因素,两者联合检测对SAP有较高诊断价值,可以为SAP早期诊断提供一定辅助作用。

Objective To observe the expression levels of human RUNT-related transcription factor 3(RUNX3)and interleukin-17(IL-17)in plasma of patients with severe acute pancreatitis(SAP),and to analyze their correlation with the progress of the disease.Methods Eighty patients with SAP in ICU were selected as the observation group,and further divided into two groups according to the APACHEⅡscore,group with score<20(n=37),and group with score>20(n=43);and another 80 healthy persons at the same period were selected as the control group.The general data of patients were recorded and compared.The levels of RUNX3 protein and IL-17 in plasma were measured by enzyme-linked immunosorbent assay(ELISA).Pearson method was used to analyze the correlations between the expression levels of RUNX3 protein,IL-17 and APACHEⅡscore;the influencing factors of SAP were analyzed by binary logistic regression;and ROC curve was used to analyze the diagnostic values of RUNX3 protein,IL-17 in plasma and their combination in SAP.Results Compared with the control group,the level of plasma RUNX3 protein in the observation group was significantly lower(P<0.05),and the level of IL-17 was significantly higher(P<0.05).Compared with the group with score<20,the expression level of RUNX3 protein in plasma of the group with score>20 was significantly lower(P<0.05),and the level of IL-17 was significantly higher(P<0.05).Pearson correlation analysis showed that there were a negative correlation between plasma RUNX3 protein level and APACHEⅡscore(P<0.05);and a positive correlation between plasma IL-17 level and APACHEⅡscore(P<0.05).The results of binary logistic regression analysis showed that low expression of plasma RUNX3 protein and high expression of IL-17 were the risk factors of SAP(P<0.05).The ROC curve showed that the areas under the ROC curve(AUC)of SAP predicting by plasma RUNX3 protein and IL-17 levels were 0.874 and 0.879,respectively;the sensitivities were 89.5%and 81.3%,respectively;and the specificities were 83.6%and 76.6%,respectively.The AUC of SAP predicting by plasma RUNX3 protein combined with IL-17 levels was 0.951,and the sensitivity and specificity were 92.5%and 83.7%,respectively.Conclusion Low expression of RUNX3 protein and high expression of IL-17 are risk factors of SAP,and the combined detection of the two has a high diagnostic value for SAP.