急性胰腺炎患者vW因子、P-选择素的变化及临床意义

Clinical significance of plasma von Willebrand factor and P-selectin in acute pancreatitis.

目的 探讨急性胰腺炎(AP)患者血浆von Willebrand因子(vWF)、P-选择素的变化及临床意义。方法 采用双抗体夹心固相酶免疫法测定34例AP患者和30例健康献血者的血浆vWF、P-选择素水平,对其进行相关性分析。结果 AP患者发病24h的血浆vWF、P-选择素水平分别为(214.6±53.2)％和(81.8±17.7)μg/L,显著高于正常对照组的(107.5±29.6)％和(14.7±4.5)μg/L(P<0.01)。重症AP患者血浆vWF、P-选择素水平分别为(251.9±62.7)％和(95.9±21.7)μg/L,显著高于轻型AP患者的(195.8±35.7)％和(73.5±16.1)μg/L(P<0.01)。vWF、P-选择素预测重症AP的敏感性、特异性和准确性分别是91.7％、86.4％、88.2％和58.3％、81.8％、73.5％。结论 AP患者存在血管内皮损伤和血小板的过度活化。测定AP患者血浆vWF水平可早期预测病情的严重程度。

Objective To discuss the clinical significance of changes in plasm von Willebrand factor(vWF) and P-selectin in acute pancreatitis(AP). Methods Plasma levels of vWF and P-selectin were measured in 34 cases of AP at 24 h of onset and 30 normal subjects by the dual radiolabeled monoclonal antibody technique. Results Plasma levels of vWF and P-selectin in patient with AP increased significantly at 24 h of onset in comparison with those in normal subjects[(214. 6 ± 53. 2)% vs (107.5 ± 29.6)% and (81. 8± 17. 7)μg/L vs (14. 7±4. 5)μg/L respectively, P<0. 01]. Plasma levels of vWF and P-selectin in severe AP increased significantly in comparison with those in mild AP [(251. 9 ±62.7% vs (195. 8±35. 7)% and (95. 9 ± 21. 7)μg/L vs (73. 5 ± 16. 1)μg/L respectively, P < 0. 01)]. The sensitivity, specificity and efficiency were 91. 7% , 86. 4% , 88. 2% for vWF, and 58. 3% , 81. 8% , 73. 5% for P-selectin in assessing the severity of pancreatitis. Conclusions vWF and P-selectin may reflect vascular endothelial injury and blood platelet activation. Plasma levels of vWF may predict the severity of AP at the early stage.