血清脂肪酶SAA表达在重型急性胰腺炎早期评估中的应用

Application of Serum Lipase and SAA Expression in the Early Assessment of Severe Acute Pancreatitis

目的:观察不同病情严重程度的急性胰腺炎患者的血清脂肪酶(LPS)与血清淀粉样蛋白(SAA)表达,分析上述血清指标在重型急性胰腺炎患者早期评估中的应用,旨在指导临床重型急性胰腺炎患者的早期治疗,促进患者良性结局。方法:回顾性分析,采集我院2018年1月至2022年1月期间收治的50例轻症急性胰腺炎患者的基线资料,并将其纳入轻症组(APACHEⅡ评分<8分),采集同时期内55例重型急性胰腺炎患者的基线资料,并将其纳入重症组(APACHEⅡ评分≥8分),对比两组患者基线资料与血清SAA、LPS表达情况,分析上述血清指标在重型急性胰腺炎患者早期评估中的应用。结果:两组患者年龄、合并高血压、合并糖尿病、合并高脂血症、性别资料对比,差异无统计学意义(P>0.05);与轻症组相比,重症组患者血清SAA、LPS均呈高表达,APACHEⅡ评分较高,差异均有统计学意义(P<0.05);建立多元Logistic回归模型,结果显示,治疗前血清SAA、LPS表达与病情严重程度有关,血清SAA、LPS过表达可能是导致患者病情加重的风险因子(OR>1,P<0.05);绘制ROC曲线,结果显示,治疗前血清SAA、LPS表达预测急性胰腺炎患者重型的AUC均>0.80,预测价值较理想;相关性分析结果显示,急性胰腺炎患者治疗前血清SAA、LPS表达与APACHEⅡ评分两两之间均呈正相关。结论:血清SAA、LPS可用于重型急性胰腺炎患者的早期评估,针对血清SAA、LPS高表达的急性胰腺炎患者应考虑为重型,临床应立即开展对应诊疗,已期促进患者良性预后。

Objective:To observe the serum lipase(LPS)and serum amyloid(SAA)expression in patients with acute pancreatitis of different severity,and analyze the application of the above serum indicators in the early assessment of patients with severe acute pancreatitis,with the aim of guiding the early treatment of patients with clinical severe acute pancreatitis and promoting benign patient outcomes.Methods:Retrospectively,baseline data of 50 patients with mild acute pancreatitis admitted to our hospital between January 2018 and January 2022 were collected and included in the mild disease group(APACHE II score<8),and baseline data of 55 patients with severe acute pancreatitis during the same period were collected and included in the severe disease group(APACHE II score≥8),and the baseline data of the two groups were compared with serum SAA and LPS expression,and the application of the above serum indicators in the early assessment of patients with severe acute pancreatitis was analyzed.Results:There was no statistically significant difference between the age,combined hypertension,combined diabetes mellitus,combined hyperlipidemia,and gender data of the two groups(P>0.05);compared with the mild disease group,the patients in the severe disease group showed high expression of serum SAA and LPS and higher APACHE II score,and the differences were statistically significant(P<0.05);multiple logistic regression model was established,and the results showed that the expression of serum SAA and LPS before treatment was related to the severity of acute pancreatitis patients,and overexpression of serum SAA and LPS might be a risk factor for aggravation of acute pancreatitis patients(OR>1,P<0.05);the ROC curve was plotted,and the results showed that the AUC of serum SAA and LPS expression before treatment to predict heavy disease in acute pancreatitis patients were all>0.80,and the predictive value were good.The results of bivariate Spearman linear correlation analysis showed that there was a positive correlation between the pre-treatment serum SAA and LPS expression and APACHE II score in patients with acute pancreatitis.Conclusion:Serum SAA and LPS can be used for the early assessment of patients with heavy acute pancreatitis,and patients with acute pancreatitis with high serum SAA and LPS expression should be considered as heavy,and the corresponding clinical treatment should be carried out immediately to promote a favorable prognosis of patients in the future.