重症急性胰腺炎患者血清NETs水平与肠黏膜屏障功能障碍的相关性

Correlation between serum NETs level and intestinal mucosal barrier dysfunction in patients with severe acute pancreatitis

[目的]观察重症急性胰腺炎(SAP)患者肠黏膜屏障功能障碍发生情况及可能导致肠黏膜屏障功能障碍的因素,分析血清中性粒细胞胞外诱捕网(NETs)的表达与肠黏膜屏障功能障碍发生的关系。[方法]接受治疗的79例SAP患者,依据入选者是否发生肠黏膜屏障功能障碍,分为发生组与未发生组,调查比较2组一般资料、检测实验室指标,并检测患者的血清NETs水平,观察并分析血清NETs水平与SAP患者发生肠黏膜屏障功能障碍的关系。[结果]79例中发生肠黏膜屏障功能障碍29例,发生率为36.71%;2组年龄、性别、体质量、合并高血压、合并糖尿病、合并血脂异常、PaO;、WBC、血淀粉酶、血尿素氮及血清白蛋白比较,差异无统计学意义(P>0.05);发生组血清CRP、PCT、IL-6、PARP-1及NETs水平均高于未发生组,差异有统计学意义(P<0.05)。经单项Logistic回归分析后建立多元回归模型结果显示,血清CRP、PCT、IL-6、PARP-1及NETs过表达是SAP患者发生肠黏膜屏障功能障碍的影响因素(OR>1,P<0.05);绘制ROC曲线结果显示,血清NETs水平预测SAP患者发生肠黏膜屏障功能障碍风险的曲线下面积(AUC)为0.833。[结论] SAP患者发生肠黏膜屏障功能障碍可能与血清NETs过表达有关,临床可考虑通过检测患者血清NETs水平,来预测肠黏膜屏障功能障碍发生风险,以指导早期干预,改善患者预后。

[Objective]To observe the occurrence of intestinal mucosal barrier dysfunction in patients with severe acute pancreatitis(SAP)and the possible role of serum neutrophil extracellular traps(NETs)in the occurrence of intestinal mucosal barrier dysfunction.[Methods]A total of 79 SAP patients treated in the hospital from January 2018 to December 2019 were selected.According to the occurrence of intestinal mucosal barrier dysfunction in the selected candidates, the patients were divided into an occurrence group and a non-occurrence group.The general information, laboratory indicators, and the serum NETs level between the two groups were investigated and compared.The relationship between serum NETs level and intestinal mucosal barrier dysfunction in SAP patients was observed and analyzed.[Results]Among all 79 SAP patients, 29 had intestinal mucosal barrier dysfunction, the incidence was 36.71%.The age, gender, body weight, the complications of hypertension, diabetes, hyperlipidemia, PaO;,WBC,blood amylase, blood urea nitrogen and serum albumin of the two groups were compared and the difference was not statistically significant(P>0.05).The serum CPR,PCT,IL-6,PARP-1 and NETs levels in the occurrence group were higher than those in the non-occurrence group, and the difference was statistically significant(P<0.05).After a single logistic regression analysis, a multiple regression model was established, the results showed that serum CPR,PCT,IL-6,PARP-1 and NETs overexpression were the influencing factors of intestinal mucosal barrier dysfunction in SAP patients(OR>1,P<0.05).The ROC curve was drawn, the results showed that the area under the curve(AUC)of serum NETs level in predicting the risk of intestinal mucosal barrier dysfunction in SAP patients was 0.833,and the predictive value was ideal.[Conclusion]Intestinal mucosal barrier dysfunction in SAP patients may be related to the overexpression of serum NETs.Clinically, the detection of serum NETs expression in patients can be considered to predict the risk of intestinal mucosal barrier dysfunction so as to guide early intervention and improve the prognosis of patients.