CAJ | 학술논문

目的了解急性胰腺炎患者血清Ghrelin水平变化对病情严重程度判断的价值.方法收集急性胰腺炎患者入院时、入院后48 h和出院时外周血标本,依据急性生理与慢性健康评分(APACHE)Ⅱ评分≥8,RANSON评分≥3分,CT评分≥4分,将患者分为轻型组、重型组,采用酶联免疫吸附法测定血清Ghrelin水平;并与APACHEⅡ评分、C反应蛋白(CRP)作相关性分析,对血清Ghrelin水平作ROC曲线分析.结果本研究共入组患者47例,其中重型胰腺炎组17例,轻型胰腺炎组30例.血清Ghrelin水平在入院24 h两组分别为(358.6±119.3) ng/L与(212.1 ±42.7) ng/L,P ＜0.001,48 h后分别为(253.1 ±71.2)与(275.5±73.6) ng/L,P=0.572,出院时为(327.8±103.8)与(319.4 ±87.1)ng/L,P=0.816.血清Ghrelin水平与APACHEⅡ评分、CRP呈正相关,ROC曲线面积0.841 ±0.057,95％可信区间为0.729～0.952.P＜0.001.结论血清Ghrelin水平在急性胰腺炎早期两组之间具有明显差异,可以作为早期预测胰腺坏死程度及临床严重程度的标志物之一.
목적 료해급성이선염환자혈청Ghrelin수평변화대병정엄중정도판단적개치.방법 수집급성이선염환자입원시、입원후48 h화출원시외주혈표본,의거급성생리여만성건강평분(APACHE)Ⅱ평분≥8,RANSON평분≥3분,CT평분≥4분,장환자분위경형조、중형조,채용매련면역흡부법측정혈청Ghrelin수평;병여APACHEⅡ평분、C반응단백(CRP)작상관성분석,대혈청Ghrelin수평작ROC곡선분석.결과 본연구공입조환자47례,기중중형이선염조17례,경형이선염조30례.혈청Ghrelin수평재입원24 h량조분별위(358.6±119.3) ng/L여(212.1 ±42.7) ng/L,P ＜0.001,48 h후분별위(253.1 ±71.2)여(275.5±73.6) ng/L,P=0.572,출원시위(327.8±103.8)여(319.4 ±87.1)ng/L,P=0.816.혈청Ghrelin수평여APACHEⅡ평분、CRP정정상관,ROC곡선면적0.841 ±0.057,95％가신구간위0.729～0.952.P＜0.001.결론 혈청Ghrelin수평재급성이선염조기량조지간구유명현차이,가이작위조기예측이선배사정도급림상엄중정도적표지물지일.
Objective To explore the value of altered serum level of Ghrelin for severity assessment in patients with acute pancreatitis (AP).Methods Peripheral blood samples were collected from 47 AP patients at admission,48 hours post-admission and at discharge.According to the criteria of APACHE Ⅱ score ≥ 8,RANSON ≥ 3,CT ≥ 4,they were divided into mild (n =17) and severe (n =30) groups.Enzyme-linked immunosorbent assay (ELISA) was used to measure the serum level of Ghrelin.And correlation analysis was made with the score of APACHE Ⅱ and the level of C reactive protein (CRP).Also the serum level of Ghrelin was analyzed with receiver operating characteristic (ROC) curve.Results The serum levels of Ghrelin after 24 h were 358.6 ± 119.3 vs 212.1 ±42.7 ng/L (P ＜0.001) ; after 48 hours,253.1 ± 71.2 vs 275.5 ± 73.6 ng/L (P =0.572) ; at discharge,327.8 ± 103.8 vs 319.4 ± 87.1 ng/L respectively (P =0.816).And serum level of Ghrelin was positively correlated with APACHE Ⅱ and CRP.ROC area under curve was 0.841 ± 0.057 and 95％ confidence interval 0.729-0.952 (P ＜ 0.001).Conclusion The serum level of Ghrelin during early-stage AP has significant differences between two groups.And it may become an early predictor of pancreatic necrosis and a degree marker of clinical severity.