MLCK、E⁃cadherin、β⁃catenin水平预测高脂血症急性胰腺炎严重程度及预后

MLCK,E⁃cadherin andβ⁃catenin levels predict the severity and prognosis of hyperlipidemia acute pancreatitis

目的探讨肌球蛋白轻链激酶(MLCK)、E⁃钙黏蛋白(E⁃cadherin)、β⁃连环蛋白(β⁃catenin)水平预测高脂血症急性胰腺炎(HAP)患者严重程度及预后。方法选取内蒙古自治区人民医院2018年6月至2020年6月收治的75例HAP患者(HAP组)与60例同期健康体检者(正常组)。HAP组根据病情严重程度分为轻症组(n=53)与重症组(n=22);以院内治疗期间预后作为标准,存活患者为良好组(n=60),死亡患者为不良组(n=15)。各组均行MLCK、E⁃cadherin、β⁃catenin的相对mRNA表达及C反应蛋白(CRP)、淀粉酶(AMY)、甘油三酯(TG)水平检测。研究外周血MLCK、E⁃cadherin、β⁃catenin与血液指标的相关性,并对MLCK、E⁃cadherin及β⁃catenin表达预测HAP预后的价值进行受试者工作特征曲线(ROC)分析。结果三组外周血MLCK、E⁃cadherin、β⁃catenin相对mRNA表达量及CRP、AMY、TG水平:重度组>轻症组>正常组,差异均有统计学意义(P<0.05)。良好组MLCK、E⁃cadherin、β⁃catenin相对mRNA表达量及CRP、AMY、TG水平显著低于不良组,差异均有统计学意义(P<0.05)。HAP患者MLCK、E⁃cadherin及β⁃catenin分别与CRP、AMY及TG呈正相关(P<0.05)。MLCK敏感性93.33%,特异性86.67%;E⁃cadherin敏感性86.67%,特异性86.67%;β⁃catenin敏感性80.00%,特异性93.33%。结论术前检测HAP患者外周血MLCK、E⁃cadherin、β⁃catenin表达可判断HAP患者病情严重程度,可作为HAP患者预后的预测指标。

Objective To investigate the clinical value of levels of early myosin light⁃chain kinase(MLCK),E⁃cadherin andβ⁃catenin in predicting the severity and prognosis of patients with hyperlipidemic acute pancreatitis(HAP).Methods 75 patients with HAP admitted to the hospital between June 2018 and June 2020 were retrospectively analyzed,and they were divided into the mild group(n=53)and the severe group(n=22)according to the severity of disease.Another 60 healthy people who came to the hospital for physical examination during the same period were selected as the normal group.Taking the prognosis during in⁃hospital treatment as the standard,the surviving patients were classified as a good group(n=60),and the dead patients were classified as an unfavorable group(n=15).The fluorescent quantitative polymerase chain reaction(qPCR)was used to detect the relative mRNA expressions of MLCK,E⁃cadherin andβ⁃catenin in peripheral mononuclear cells.Immunoturbidimetry was applied to detect the level of serum C⁃reactive protein(CRP),and EPS substrate method was used doe detection of serum amylase(AMY)level and glycerol kinase method for serum triglyceride(TG)level.The correlation between peripheral blood MLCK,E⁃cadherin andβ⁃catenin and blood indicators was observed,and the value of expressions of MLCK,E⁃cadherin andβ⁃catenin in predicting the prognosis of HAP was analyzed by receiver operating characteristic curve(ROC).Results The relative mRNA expressions of MLCK,E⁃cadherin andβ⁃catenin in peripheral blood and the levels of CRP,AMY and TG in the three groups:severe group>mild group>normal group,the differences were statistically significant(P<0.05).The relative mRNA expressions of MLCK,E⁃cadherin andβ⁃catenin and the levels of CRP,AMY,and TG in the good group were significantly lower than those in the poor group,and the differences were statistically significant(P<0.05).The relative mRNA expression levels of peripheral blood MLCK,E⁃cadherin andβ⁃catenin were significantly lower in good group than those in poor group(P<0.05),and the levels of CRP,AMY,and TG were significantly lower than those in poor group(P<0.05).MLCK,E⁃cadherin andβ⁃catenin were positively correlated with CRP,AMY and TG in HAP patients(P<0.05).The ROC curve results showed that the cut⁃off value,area under the curve,sensitivity and specificity in predicting the poor prognosis of patients with HAP were 2.22,0.882,93.33%and 86.67%of MLCK,and were 1.99,0.851,86.67%and 86.67%of E⁃cadherin and were 1.65,0.809,80.00%and 93.33%ofβ⁃catenin.Conclusion Preoperative detection of the expressions of MLCK,E⁃cadherin andβ⁃catenin in peripheral blood of HAP patients can judge the severity of HAP patients and can be used as predictors of the prognosis of HAP patients.