血清SAA、CRP、ACE 2对重症胰腺炎的临床诊断价值分析

The Clinical Diagnostic Value of Serum SAA,CRP and ACE 2 in Severe Pancreatitis

目的分析血清淀粉样蛋白A(SAA)、C反应蛋白(CRP)和血管紧张素转化酶2(ACE 2)水平在急性胰腺炎,尤其是重症胰腺炎临床诊断中的应用价值。方法选取2017年10月至2019年10月本院收治的100例急性胰腺炎患者,其中61例轻症急性胰腺炎为轻症组,39例重症急性胰腺炎为重症组;同时选取同期来院体检的100例健康志愿者为对照组。采集治疗前空腹静脉血,分离血清,采用ELISA实验检测血清SAA、CRP和ACE 2水平。结果重症组SAA、CRP水平明显高于轻症组,且均高于对照组,差异具有统计学意义(P<0.05);重症组ACE 2水平明显低于轻症组,且均低于对照组,差异具有统计学意义(P<0.05)。39例重症急性胰腺炎患者血清SAA水平与CRP呈正相关(r=0672,P<0.01);SAA与ACE 2呈负相关(r=-0.619,P<0.05);CRP与ACE 2呈负相关(r=-0.525,P<0.05)。三者联合诊断急性胰腺炎和预测重症急性胰腺炎的ROC曲线下面积分别为0.822、0.807。结论重症急性胰腺炎患者血清SAA、CRP和ACE与病情严重程度具有一定关系,三者联合检测诊断急性胰腺炎和预测重症急性胰腺炎具有较高的临床价值。

Objective To analyze the clinical value of serum amyloid A(SAA),C-reactive protein(CRP)and angiotensin-converting enzyme 2(ACE 2)levels in the diagnosis of acute pancreatitis,especially severe pancreatitis.Methods A total of 100 patients with acute pancreatitis admitted to our hospital from October,2017 to October,2019 were selected in this study,including 61 patients with mild acute pancreatitis defined as the mild group,and 39 patients with severe acute pancreatitis defined as the severe group.At the same time,100 healthy volunteers were selected as a control group.Fastening venous blood was collected from patients before treatment,and the supernatant was separated to detect serum levels of SAA,CRP and ACE 2 by ELISA kits.Results Levels of SAA and CRP in the severe disease group were significantly higher than those in the mild disease group,and both were higher than those in the control group,with statistical significances(P<0.05).The level of ACE 2 in the severe group was significantly lower than that of the mild group,and lower than that of the control group,with a statistical significance(P<0.05).Serum SAA level was positively correlated with CRP in 39 patients with severe acute pancreatitis(r=0.672,P<0.01);There was a negative correlation between SAA and ACE 2(r=-0.619,P<0.05);There was a negative correlation between CRP and ACE 2(r=-0.525,P<0.05).The areas under the ROC curve of the combined diagnosis of acute pancreatitis and the prediction of severe acute pancreatitis were 0.822 and 0.807,respectively,which were all larger than that of the single detection.Conclusion Serum levels of SAA and CRP have correlations with the severity of the disease,and their combined detection had a high clinical diagnosis value for acute pancreatitis and severe acute pancreatitis.