血清降钙素原联合miR-217对急性胰腺炎病情严重程度及预后的评估价值

Value of serum procalcitonin combined with miR-217 in diagnosis and prognosis of acute pancreatitis

目的探究血清降钙素原(PCT)和miR-217与急性胰腺炎(AP)病情严重程度的关系,并分析两者联合检测对AP预后的预测价值。方法选择2020年1月至2021年6月无锡市第五人民医院收治的147例AP患者作为研究对象,设为AP组。根据AP病情严重程度将患者分为轻度组(33例)、中度组(71例)和重度组(43例),另根据患者预后情况将其分为预后良好组(85例)和预后不良组(62例)。另选择同期于该院进行健康体检的147名志愿者设为健康组。采用ELISA法检测各组血清PCT表达水平。采用实时荧光定量PCR法检测各组血清miR-217表达水平。采用多因素logistic回归模型分析影响AP预后不良的危险因素。采用ROC曲线分析血清PCT和miR-217表达水平对AP预后不良的预测价值。结果与健康组相比,AP组的血清PCT、miR-217表达水平均显著升高,差异均有统计学意义(P均<0.05)。与轻度组相比,中度组、重度组的血清PCT、miR-217表达水平均显著升高(P均<0.05);与中度组相比,重度组的血清PCT、miR-217表达水平均显著升高(P均<0.05)。与预后良好组相比,预后不良组的血清PCT、miR-217表达水平均显著升高(P均<0.05)。多因素logistic回归模型分析结果显示,高脂血症、急性生理学与慢性健康状况评分系统Ⅱ(APACHEⅡ)评分、胰腺坏死范围、血尿素氮(BUN)、PCT和miR-217均是AP预后不良的独立危险因素(P均<0.05)。ROC曲线分析结果显示,血清PCT和miR-217联合检测预测AP患者发生预后不良的曲线下面积(AUC)为0.854,分别大于单项检测,且联合检测的敏感度最高。结论血清PCT和miR-217表达水平均与AP病情严重程度密切相关,两者联合检测对于AP预后不良具有较高的预测价值。

Objective This paper is to investigate the relationship between serum procalcitonin(PCT)and miR-217 and the severity of acute pancreatitis(AP),and to analyze the value of combined detection for AP prognosis.Methods One hundred and forty-seven AP patients admitted to the Fifth People's Hospital of Wuxi from January 2020 to June 2021 were selected as the study subjects and set as the AP group.According to the severity of AP disease,the patients were assigned to the mild group(33 cases),the moderate group(71 cases),and the severe group(43 cases),who were divided into the good prognosis group(85 cases)and the poor prognosis group(62 cases)based on the prognosis of the patients.Another 147 volunteers who underwent physical examination in the same period were assigned to the health group.The expression level of serum PCT in each group was detected by ELISA.The Real-time fluorescence quantitative PCR was used to detect the expression level of serum miR-217 in each group.The logistic regression model was used to analyze the risk factors affecting the poor prognosis of AP.The ROC curve was used to analyze the predictive value of serum PCT and miR-217 expression levels for poor prognosis of AP.Results Compared with the healthy group,the expression levels of serum PCT and miR-217 in the AP group are increased,with statistically significant differences(P<0.05).Compared with the mild group,the expression levels of serum PCT and miR-217 in the moderate group and the severe group are significantly increased(P<0.05).Compared with the moderate group,the expression levels of serum PCT and miR-217 in the severe group are significantly increased(P<0.05).Compared with the good prognosis group,the expression levels of serum PCT and miR-217 in the poor prognosis group are significantly increased(P<0.05).The multivariate logistic regression model analysis shows that hyperlipidemia,Acute Physiology and Chronic Health EvaluationⅡ(APACHEⅡ)score,pancreatic necrosis range,blood urea nitrogen(BUN),PCT,and miR-217 are independent risk factors for poor prognosis of AP(P<0.05).The ROC curve analysis shows that the area under the curve(AUC)of the combined detection of serum PCT and miR-217 to predict poor prognosis in AP patients is 0.854,which is higher than that of the single detection,and the combined detection has the highest sensitivity.Conclusion The expression levels of serum PCT and miR-217 are closely related to the severity of AP disease,and the combined detection of both has a high predictive value for the poor prognosis of AP.