| 涂贵新,杨谢梅,林正泽,等.急性胰腺炎病人血清白三烯 B4、可溶性分化簇 163水平与病情严重程度的关系分析[J].安徽医药,2025,29(8):1656-1660. |
| 急性胰腺炎病人血清白三烯 B4、可溶性分化簇 163水平与病情严重程度的关系分析 |
| Analysis of the relationship between serum LTB4, and sCD163 levels and the severity of acute pancreatitis in patients |
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| DOI：10.3969/j.issn.1009-6469.2025.08.035 |
| 中文关键词: 胰腺炎 白三烯 B4 可溶性分化簇 163 病人病情 诊断 |
| 英文关键词: Pancreatitis Leukotriene B4 Soluble differentiation cluster 163 Patient acuity Diagnostic |
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| 中文摘要: |
| 目的分析急性胰腺炎( AP)病人血清白三烯 B4(LTB4)、可溶性分化簇 163(sCD163)水平与病情严重程度的关系。方法选取 2019年 7月至 2022年 7月遂宁市中心医院收治的 AP病人 114例作为研究对象，根据病人的病情严重程度分为轻症组 66例，重症组 48例，另选取同期健康体检者 114例为健康组。酶联免疫吸附分析(ELISA)检测血清 LTB4、sCD163、肿瘤坏死因子 α(TNF-α)、白细胞介素 -6(IL-6)和 C反应蛋白( CRP)水平；采用 Pearson法分析血清 LTB4、sCD163表达水平以及二者与炎症指标的相关性，采用 Spearman法分析血清 LTB4、sCD163与急性生理学和慢性健康状况评价 Ⅱ(APACHE Ⅱ)评分和 Ranson评分的相关性；采用 logistic回归分析影响重症 AP的因素；受试者操作特征曲线( ROC曲线)来分析血清 LTB4、sCD163水平对重症 AP的诊断价值。结果重症组和轻症组 LTB4［(310.58±100.21)μg/L、(249.78±53.67)μg/L比( 13.71±4.36)μg/L］、 sCD163［( 1.01±0.30)mg/L、(0.39±0.11)mg/L比( 0.30±0.07)mg/L］、 TNF-α、IL-6、CRP水平显著高于健康组( P<0.05)，重症组 LTB4、 sCD163、TNF-α、IL-6、CRP、APACHE Ⅱ评分和 Ranson评分显著高于轻症组( P<0.05)。根据 Pearson相关性分析， LTB4、sCD163呈正相关( P<0.05)， LTB4、sCD163与 TNF-α、IL-6、CRP呈正相关( P<0.05)，根据 Spearman相关性分析， LTB4、sCD163与 APACHE Ⅱ评分和 Ranson评分呈正相关( P<0.05)。根据 logistic回归分析得知， LTB4、sCD163高表达是重症 AP的危险因素(P<0.05)。根据 ROC曲线得知，血清 LTB4诊断重症 AP的曲线下面积(AUC)为 0.83，血清 sCD163诊断重症 AP的 AUC为 0.88，二者联合诊断重症 AP的 AUC为 0.93，二者联合诊断优于各自单独诊断( Z联合 /LTB4=3.15、Z联合 /sCD163=1.82，P=0.001、0.034)。结论 |
| 英文摘要: |
| Objective To analyze the relationship between serum leukotriene B4 (LTB4), soluble differentiation cluster 163(sCD163) levels and the severity of acute pancreatitis (AP).Methods One hundred and fourteen patients with AP admitted to SuiningCentral Hospital from July 2019 to July 2022 were selected as the study subjects, and they were assigned into 66 cases in the mildgroup and 48 cases in the severe group according to the severity of the patients' conditions, and 114 cases of healthy medical checkupsduring the same period were also selected as the health group. Enzyme-linked immunosorbent assay (ELISA) was used to detect the lev-els of serum LTB4, sCD163, tumor necrosis factor (TNF-α), interleukin-6 (IL-6), and C-reactive protein (CRP); Pearson's method wasused to analyze the expression levels of serum LTB4, sCD163, and the correlation between the two and inflammatory indexes, andSpearman method was used to analyze the correlation of serum LTB4 and sCD163 with acute physiological function and chronic healthevaluation Ⅱ (APACHE Ⅱ) score and Ranson score; logistic regression was used to analyze the influencing factors of severe AP; andsubject operating characteristic curves (ROC curves) were used to analyze the diagnostic value of serum LTB4, sCD163 levels for se-vere AP.Result LTB4 [(310.58±100.21) μg/L, (249.78±53.67) μg/L vs. (13.71±4.36) μg/L], sCD163 [(1.01±0.30) mg/L, (0.39±0.11) mg/L vs. (0.30±0.07) mg/L], and TNF-α in the severe group and the mild group, IL-6, and CRP levels were significantly higher than those in the health group (P<0.05), and LTB4, sCD163, TNF-α, IL-6, and CRP in the severe group, APACHE Ⅱ score and Ranson score were significantly higher than those in the mild group (P<0.05). According to Pearson correlation analysis, LTB4 and sCD163 were positively correlated (P<0.05), and LTB4 and sCD163 were positively correlated with TNF-α, IL-6,and CRP (P<0.05), and ac-cording to Spearman correlation analysis, LTB4 and sCD163 were positively correlated with both APACHE Ⅱ score and Ranson score(P<0.05). According to logistic regression analysis, it was learned that high expression of LTB4 and sCD163 was a risk factor for severe AP (P<0.05). According to the ROC curve, the area under the curve (AUC) of serum LTB4 for diagnosis of severe AP was 0.83, theAUC of serum sCD163 for diagnosis of severe AP was 0.88, and the AUC of the combination of the two for diagnosis of severe AP was0.93, and the combination of the two diagnoses was superior to the diagnosis of each alone (Zcombination/LTB4=3.15, Zcombination/sCD163=1.82, P= 0.001, 0.034).Conclusion Serum levels of LTB4 and sCD163 are elevated in AP patients, and both are associated with the severity ofthe disease, and the combination of the two can better diagnose severe AP. |
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