CAJ | 학술논문

目的：比较 C-反应蛋白(CRP)和鞘氨醇激酶-1(SphK1)在预测急性胰腺炎(AP)严重程度方面的价值。方法选取2012年12月—2013年7月收治的30例 AP 患者,分为轻型 AP(MAP)组17例和重型 AP(SAP)组13例,另外纳入10例健康者作为健康对照组。 AP 患者在症状发生后、健康者在被选入组后48 h、72 h、5 d、7 d 时分别检测血清 CRP、外周血白细胞中 SphK1 mRNA 及其活性。结果 MAP 组和 SAP 组患者血清 CRP 的水平、外周血白细胞中SphK1 mRNA、SphK1活性4个时间都高于健康对照组(P <0.05),但血清 CRP 的含量在 MAP 组和 SAP 组之间均无统计学差异(P >0.05)。48 h、72 h、5 d 时,SAP 组外周血白细胞中 SphK1 mRNA、SphK1活性都高于 MAP 组(P <0.05)；7 d 时 SAP 组和 MAP 组的 SphK1 mRNA、SphK1活性均无统计学差异(P >0.05)。在48 h 时,SphK1的诊断灵敏度和诊断准确性最高,而且 ROC 曲线下面积高达0.946。结论在早期预测 AP 严重程度方面,与血清 CRP 相比,测定外周血白细胞中的 SphK1是一个更好的方法。
목적：비교 C-반응단백(CRP)화초안순격매-1(SphK1)재예측급성이선염(AP)엄중정도방면적개치。방법선취2012년12월—2013년7월수치적30례 AP 환자,분위경형 AP(MAP)조17례화중형 AP(SAP)조13례,령외납입10례건강자작위건강대조조。 AP 환자재증상발생후、건강자재피선입조후48 h、72 h、5 d、7 d 시분별검측혈청 CRP、외주혈백세포중 SphK1 mRNA 급기활성。결과 MAP 조화 SAP 조환자혈청 CRP 적수평、외주혈백세포중SphK1 mRNA、SphK1활성4개시간도고우건강대조조(P <0.05),단혈청 CRP 적함량재 MAP 조화 SAP 조지간균무통계학차이(P >0.05)。48 h、72 h、5 d 시,SAP 조외주혈백세포중 SphK1 mRNA、SphK1활성도고우 MAP 조(P <0.05)；7 d 시 SAP 조화 MAP 조적 SphK1 mRNA、SphK1활성균무통계학차이(P >0.05)。재48 h 시,SphK1적진단령민도화진단준학성최고,이차 ROC 곡선하면적고체0.946。결론재조기예측 AP 엄중정도방면,여혈청 CRP 상비,측정외주혈백세포중적 SphK1시일개경호적방법。
Objective To compare the forecasting value of C-reactive protein (CRP) and Sphingosine Kinase 1 (SphK1) in diagnosis of the severity of the acute pancreatitis (AP). Methods A total of 30 patients with AP during De-cember 2012 and July 2013 were divided into severe acute pancreatitis group (SAP group, n =13) and mild acute pancrea-titis group (MAP group, n =17). Ten healthy volunteers were selected as control group. The levels of serum CRP, SphK1 mRNA and SphK1 enzymatic activity of peripheral blood leucocyte were measured in AP patients at 48 h, 72 h, 5 d and 7 d after the attack of AP. Results At 48 h, 72 h, 5 d and 7 d, the levels of serum CRP, SphK1 mRNA and SphK1 enzy-matic activity of peripheral blood leucocyte in patients with MAP and SAP were elevated, compared with those in control group (P <0. 05); while the difference in serum CRP level was not statistically significant between MAP and SAP groups (P >0. 05). The levels of SphK1 mRNA and SphK1 enzymatic activity of peripheral blood leucocyte in SAP patients were elevated, compared with those in MAP patients at 48 h, 72 h and 5 d (P <0. 05); the differences in level of SphK1 mRNA and SphK1 enzymatic activity of peripheral blood leucocyte were not statistically significant at 7 d between MAP and SAP groups (P >0. 05). The highest sensitivity and diagnostic accuracy of SphK1 were observed at 48 h after the AP attack, and the area under ROC curve was up to 0. 946. Conclusion The value of measurement of SphK1 of peripheral blood leu-cocyte is preferred in the early prognosis of AP, compared with those by CRP.