血清脂肪因子在急性胰腺炎病情判断和预后中的临床意义

Clinical significance of serum adipokines in judgment and prognosis of acute pancreatitis

目的探讨血清抵抗素(Resistin)、瘦素(Leptin)和内脏脂肪素(Visfatin)在急性胰腺炎(AP)病情判断和预后中的临床意义。方法选择2019年1月至2020年12月该院收治的121例AP患者为AP组,另选择同期该院75例体检健康者为对照组。采用酶联免疫吸附试验检测2组血清Resistin、Leptin和Visfatin水平。比较2组血清Resistin、Leptin和Visfatin水平,分析这3项指标在不同严重程度和预后AP患者中的差异,采用Pearson相关分析这3项指标间的相关性,采用受试者工作特征曲线分析这3项指标对AP预后不良的预测效能。结果AP组血清Resistin和Leptin水平明显高于对照组(P<0.05),并随着AP严重程度的升高而升高(P<0.05),AP预后不良组血清Resistin和Leptin水平明显高于预后良好组(P<0.05);AP组血清Visfatin水平明显低于对照组(P<0.05),并随着AP严重程度升高而降低(P<0.05),AP预后不良组血清Visfatin水平明显低于预后良好组(P<0.05)。AP患者血清Visfatin水平与Resistin、Leptin呈负相关(r=-0.687、-0.714,P<0.05),血清Resistin水平与Leptin呈正相关(r=0.742,P<0.05)。血清Resistin、Leptin和Visfatin联合检测预测AP预后不良的灵敏度为88.5%,特异度为95.8%,曲线下面积(AUC)为0.970,其AUC明显高于Resistin、Leptin和Visfatin单独检测的AUC(Z=2.670、3.130、3.185,P<0.05)。结论血清Resistin、Leptin和Visfatin在AP病情判断和预后预测中具有重要的临床价值,3项指标联合检测预测AP预后不良的效能更高。

Objective To investigate the clinical significance of serum resistin,leptin and visfatin in the judgment and prognosis of acute pancreatitis(AP).Methods A total of 121 patients with AP who were diagnosed and treated in the hospital from January 2019 to December 2020 were selected as the AP group,and 75 people of healthy physical examination in the hospital during the same period were selected as the control group.The serum levels of resistin,leptin and visfatin in the two groups were detected by enzyme-linked immunosorbent assay.The serum levels of resistin,leptin and visfatin were compared between the two groups,and the differences of the three indicators in AP patients with different severity and prognosis were analyzed.Pearson correlation was used to analyze the correlation among the three indicators,and receiver operating characteristic curve was used to analyze the predictive efficacy of the three indicators for poor prognosis in AP.Results The serum levels of resistin and leptin in the AP group were significantly higher than those in the control group(P<0.05),and the levels increased with the severity of AP(P<0.05).The serum levels of resistin and leptin in the poor prognosis group were significantly higher than those in the good prognosis group(P<0.05).The serum level of visfatin in the AP group was significantly lower than that in the control group(P<0.05),and the level decreased with the increase in the severity of AP(P<0.05).The serum level of visfatin in the poor prognosis group was significantly lower than that in the good prognosis group(P<0.05).The serum level of visfatin in AP patients was negatively correlated with resistin and Leptin(r=-0.687,-0.714,P<0.05),and the serum level of resistin was positively correlated with Leptin(r=0.742,P<0.05).The sensitivity of combined detection of resistin,leptin and visfatin in predicting poor prognosis of AP was 88.5%,and the specificity was 95.8%,and the area under the curve(AUC)was 0.970.The AUC was significantly higher than that of resistin,leptin and visfatin alone(Z=2.670,3.130,3.185,P<0.05).Conclusion Serum resistin,leptin and visfatin have important clinical value in the judgment and prognosis prediction of AP,and the combined detection of the three indicators has higher efficacy in predicting poor prognosis of AP.