| 王琼,魏莉娟,伍勇彬.血清 HMGB1和 PTEN蛋白水平在急性胰腺炎严重程度及预后评估中的临床价值[J].安徽医药,2025,29(8):1613-1618. |
| 血清 HMGB1和 PTEN蛋白水平在急性胰腺炎严重程度及预后评估中的临床价值 |
| Clinical value of serum HMGB1 and PTEN protein levels in evaluating the severity and prognosis of acute pancreatitis |
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| DOI：10.3969/j.issn.1009-6469.2025.08.025 |
| 中文关键词: 急性胰腺炎 高迁移率族蛋白 B1 磷酸酶与张力蛋白同源物 急性生理学和慢性健康状况评价 Ⅱ 预后 |
| 英文关键词: Acute pancreatitis High mobility group protein B1 Phosphatase and tensin homologues Acute physiology and chronic health evaluation Ⅱ Prognosis |
| 基金项目:四川大学华西护理学科发展专项基金项目( HXHL20004) |
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| 中文摘要: |
| 目的探究血清高迁移率族蛋白 B1(HMGB1)和磷酸酶与张力蛋白同源物( PTEN)蛋白水平与急性胰腺炎( AP)严重程度及预后的关系。方法选取资阳市中心医院 2021年 3月至 2022年 11月收治的 119例 AP病人，采用酶联免疫吸附分析检测病人血清 HMGB1和 PTEN蛋白水平；根据胰腺内和周围器官以及全身器官的损伤程度将病人划分为重度 AP组( 54例)、中度 AP组( 29例)和轻度 AP组( 36例)比较三组病人血清 HMGB1和 PTEN蛋白水平并分析其与急性生理学和慢性健康状况评价 Ⅱ(APACHE Ⅱ)评分、胰腺炎严重程，度评分( Ranson评分)、改良 CT严重指数( MCTSI)评分、器官功能障碍( Marshall)评分的相关性；根据病人入院后 28 d内身体状况将病人分为生存组( 91例)和死亡组( 28例)并评估影响病人预后的因素。通过受试者操作特征曲线( ROC曲线)评估血清 HMGB1和 PTEN水平对急性胰腺炎严重程度和，预后预测价值。结果轻度、中度、重度 AP组血清 HMGB1水平［(6.31±2.67)μg/L、(15.36±5.22)μg/L、(19.15±4.78)μg/L］和 APACHE Ⅱ评分、 Ranson评分、 MCTSI评分、 Marshall评分依次升高，血清 PTEN水平［( 1.02±0.31)ng/L、(0.75±0.22)ng/L、(0.53±0.19)ng/L］依次降低，组间比较差异有统计学意义( P<0.05)。 Pearson分析表明， AP病人 HMGB1水平与 APACHE Ⅱ评分、 Ranson评分、 MCTSI评分、 Marshall评分呈正相关， PTEN水平和 APACHE Ⅱ评分、 Ranson评分、 MCTSI评分、 Marshall评分呈负相关( P<0.05)。生存组和死亡组身体质量指数(BMI)、呼吸频率比较，差异有统计学意义( P<0.05)；生存组血清 HMGB1水平［(10.01±3.89)μg/L比( 28.43±5.36)μg/L］、 Ranson评分、 MCTSI评分、 Marshall评分显著低于死亡组， PTEN水平［( 0.81±0.27)ng/L比( 0.48±0.10)ng/L］显著高于死亡组( P<0.05)。 logistic回归分析表明，血清 HMGB1是 AP病人死亡的独立危险因素， PTEN是其保护因素(P<0.05)； ROC曲线分析结果表明，血清 HMGB1和 PTEN二者联合检测评估 AP病人病情严重程度的曲线下面积( AUC)值优于单独检测( ZHMGB1-联合 =2.10，P=0.036； ZPTEN-联合 =2.81，P=0.005)；血清 HMGB1和 PTEN联合预测 AP病人预后的 AUC优于单独检测( ZHMGB1-联合 =2.16，P=0.031；ZPTEN-联合 = |
| 英文摘要: |
| Objective To investigate the relationship between serum high mobility group protein B1 (HMGB1) and phosphatase andtensin homolog (PTEN) levels and the severity and prognosis of acute pancreatitis (AP).Methods A total of 119 AP patients admitted to Ziyang Central Hospital from March 2021 to November 2022 were collected, enzyme-linked immunosorbent assay (ELISA) was ap-plied to analyze the serum levels of HMGB1 and PTEN proteins in patients; patients were grouped into severe AP group (54 cases),moderate AP group (29 cases), and mild AP group (36 cases) based on the degree of damage to the pancreas, surrounding organs, andsystemic organs; the serum levels of HMGB1 and PTEN proteins were compared among three groups, and their correlation with acutephysiology and chronic health evaluation Ⅱ (APACHE Ⅱ) scores, pancreatitis severity score (Ranson scores), modified CT severity in-dex (MCTSI) scores and organ dysfunction (Marshall) scores were analyzed; according to the patient's physical condition within 28 daysafter admission, they were grouped into a survival group (91 cases) and a death group (28 cases), and factors affecting the patient's prog-nosis were evaluated. Receiver operating characteristic curve (ROC) was applied to evaluate the predictive value of serum HMGB1 andPTEN protein levels for the severity and prognosis of acute pancreatitis. Results The level of serum HMGB1 [(6.31±2.67) μg/L,(15.36±5.22) μg/L, (19.15±4.78) μg/L] and APACHE Ⅱ scores, Ranson scores, MCTSI scores and Marshall scores increased in themild AP group, moderate AP group, and severe AP group, while the level of serum PTEN [(1.02±0.31) ng/L,(0.75±0.22) ng/L,(0.53±0.19) ng/L] decreased in turn (P<0.05). Pearson analysis showed that the serum HMGB1 level in AP patients was positively correlated with APACHE Ⅱ score, Ranson scores, MCTSI scores and Marshall scores, while PTEN level was negatively correlated with APACHEⅡ score, Ranson scores, MCTSI scores and Marshall scores (P<0.05). Body mass index (BMI) and respiratory rate were obviously differ-ent between the survival group and the death group (P<0.05); the serum HMGB1 level [(10.01±3.89) μg/L vs. (28.43±5.36) μg/L], Ran.son scores, MCTSI scores and Marshall scores in the survival group was obviously lower than that in the death group, and the PTEN lev-el [(0.81±0.27) ng/L vs. (0.48±0.10) ng/L] was obviously higher than that in the death group (P<0.05). The results of logistic regressionanalysis showed that serum HMGB1 was an independent risk factor for death in AP patients, and PTEN was its protective factor (P< 0.05); ROC curve analysis results indicated that the area under the curve (AUC) value of the combined detection of serum HMGB1 andPTEN in assessing the severity of AP patients was better than that of individual detection (ZHMGB1-combined detection=2.10, P=0.036; ZPTEN-combined de.tection=2.81, P=0.005); the AUC value of the combined detection of serum HMGB1 and PTEN in predicting the prognosis of AP patientswas better than the single detection (ZHMGB1-combined detection=2.16, P=0.031; ZPTEN-combined detection=2.92, P=0.004). Conclusion The serum HMGB1 level is positively correlated with the AP severity while PTEN level is negatively correlated with the severity. The combinationof the two provides high predictive value for the severity and prognosis of patients. |
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