高脂血症胰腺炎患者血清血管紧张素转化酶2与巨噬细胞移动抑制因子水平检测及临床意义

Detection of serum angiotensin converting enzyme 2 and macrophage migration inhibitory factor in patients with hyperlipidemic pancreatitis and its clinical significance

目的探究高脂血症胰腺炎患者血清血管紧张素转化酶2(angiotensin converting enzyme 2,ACE2)与巨噬细胞移动抑制因子(migration inhibitory factor,MIF)水平检测及临床意义。方法回顾性分析我院收治的高脂血症急性胰腺炎患者86例的病历资料,根据3个月复查结局分为预后良好组和预后不佳组,分析影响高脂血症胰腺炎预后的相关因素,以受试者工作特征(receiver operator characteristic,ROC)曲线下面积(area under the curve,AUC)评估血清ACE2、MIF水平对高脂血症急性胰腺炎预后的预测价值。结果预后不佳组胰腺炎Balthazar CT评级D级占比、血清MIF、三酰甘油(triacylglycerol,TG)、低密度脂蛋白胆固醇(low density lipoprotein cholesterol,LDL-C)水平均高于预后良好组,ACE2、高密度脂蛋白胆固醇(high density lipoprotein cholesterol,HDL-C)水平低于预后良好组(P<0.05)。Logistic多因素回归分析结果显示,Balthazar CT评级D级占比及血清MIF、TG、LDL-C表达量升高及ACE2、HDL-C表达量降低均为高脂血症急性胰腺炎预后不佳的危险因素(P<0.05)。ROC分析显示,血清ACE2、MIF水平单一及联合对高脂血症急性胰腺炎预后ROC预测的AUC分别为0.754(95%CI:0.681~0.827)、0.759(95%CI:0.691~0.828)、0.827(95%CI:0.785~0.867)。结论血清MIF表达水平升高与血清ACE2水平降低均与高脂血症急性胰腺炎患者预后相关,且二者预测高脂血症急性胰腺炎预后效能良好。

Objective To explore the detection and clinical significance of serum angiotensin converting enzyme 2(ACE2)and macrophage migration inhibitory factor(MIF)in patients with hyperlipidemic pancreatitis.Methods The medical records of 86 patients with hyperlipidemic acute pancreatitis(HLAP)admitted to our hospital were retrospectively analyzed.According to the results of the three-month review,they were divided into a good prognosis group and a poor prognosis group.The relevant factors affecting the prognosis of hyperlipidemic pancreatitis were analyzed.The predictive value of serum ACE2 and MIF levels on the prognosis HLAP was evaluated by the area under the receiver operator characteristic(ROC)curve(AUC).Results Balthazar′s CT grade D,serum levels of MIF,triacylglycerol(TG)and low density lipoprotein cholesterol(LDL-C)were higher in the poor prognosis group than those in the good prognosis group,while the levels of ACE2 and high density lipoprotein cholesterol(HDL-C)were lower than those in the good prognosis group(P<0.05).Multivariate Logistic regression analysis showed that the proportion of Balthazar′s CT grade D,the increase of serum MIF,TG,LDL-C expression and the decrease of ACE2,HDL-C expression were risk factors for poor prognosis of HLAP(P<0.05).ROC analysis showed that the AUC of serum ACE2 and MIF alone and in combination in predicting the prognosis of HLAP was 0.754(95%CI:0.681-0.827),0.759(95%CI:0.691-0.828)and 0.827(95%CI:0.785-0.867),respectively.Conclusion Both the increase of serum MIF expression level and the decrease of serum ACE2 level are related to the prognosis of patients with HLAP,and both of them are effective in predicting the prognosis of HLAP.