CAJ | 학술논문

目的：探讨sB7-H3（可溶性B7-H3）对早期判断急性胰腺炎（AP）严重程度的临床价值。方法：选择AP患者75例（轻度MAP 30例、中度MSAP 20例、重度SAP 25例），对照组为健康（HC）组20例，采用双抗体夹心ELISA法测腹痛开始24 h血浆sB7-H3值，评价与胰腺炎严重程度关联性的敏感度和特异度，及与临床检测指标相关性分析。结果：腹痛24 h 血浆sB7-H3值，AP组显著高于对照组（t＝3．925， P＝0．0002），MAP 组与 HC 相相比差异没有显著性，MSAP 组和 SAP 组均显著高于 HC 组（P＜0．05和 P＜0．01）和MAP组（P＜0．05和P＜0．01）；SAP组显著高于MSAP组（P＜0．01）。 sB7-H3与 LDH、hs-CRP、WBC 呈线性正相关，与ALB、Ca（S）呈线性负相关（均 P＜0．05）；sB7-H3对判断中度以上胰腺炎敏感度为88．9％，特异度为83．3％，判断SAP的敏感度为96％，特异度96％。结论：sB7-H3对急性胰腺炎严重程度早期判断有重要临床价值，同时有很高的敏感度、特异度，与临床判断严重程度指标呈线性相关。
목적：탐토sB7-H3（가용성B7-H3）대조기판단급성이선염（AP）엄중정도적림상개치。방법：선택AP환자75례（경도MAP 30례、중도MSAP 20례、중도SAP 25례），대조조위건강（HC）조20례，채용쌍항체협심ELISA법측복통개시24 h혈장sB7-H3치，평개여이선염엄중정도관련성적민감도화특이도，급여림상검측지표상관성분석。결과：복통24 h 혈장sB7-H3치，AP조현저고우대조조（t＝3．925， P＝0．0002），MAP 조여 HC 상상비차이몰유현저성，MSAP 조화 SAP 조균현저고우 HC 조（P＜0．05화 P＜0．01）화MAP조（P＜0．05화P＜0．01）；SAP조현저고우MSAP조（P＜0．01）。 sB7-H3여 LDH、hs-CRP、WBC 정선성정상관，여ALB、Ca（S）정선성부상관（균 P＜0．05）；sB7-H3대판단중도이상이선염민감도위88．9％，특이도위83．3％，판단SAP적민감도위96％，특이도96％。결론：sB7-H3대급성이선염엄중정도조기판단유중요림상개치，동시유흔고적민감도、특이도，여림상판단엄중정도지표정선성상관。
Objective To investigate the clinical value of sB7-H3 in predicting the severity of acute pancreatitis at early stage. Methods By using the double antibody sandwich ELISA method, the level of plasma sB7-H3 was measured at 24h after onset of abdominal pain in 75 patients with acute pancreatitis (MAP30, MSAP20, SAP25), and 20 healthy persons were enrolled in the controlgroup.The sensitivity and specificity correlations of sB7-H3 in acute pancreatitis with severity degree , as well as with the clinical detection index , were also evaluated. Results The level of plasma sB7-H3 at 24 h in the AP group was significantly higher than that in the healthy control ( HC) group (t = 3.925, P = 0.0002), however, no significant difference was found between the MAP groep and the HC group (P>0.05). The levels of plasma sB7-H3 in the MSAP and the SAP group were significantly higher than that in the HC group (P<0.05和P<0.001)or the MAP group (P<0.05 和P<0.01);The level of plasma sB7-H3 in the SAP group was also markedly higher than that in the MSAP group (P < 0.01). sB7-H3 had a linear positive correlation with LDH、hs-CRP、WBC(P<0.05). ALB had a linear negative correlation with and Ca (S)(P<0.05). By the cutoff of sB7-H3, the sensitivity and specificity to judgethe above moderate pancreatitis were 88.9%and 83.3%,and to judgethe SAP were 96%and 96%. Conclusion sB7-H3 has important clinical value to judge the severity of acute pancreatitis at early time with high sensitivity and specificity , with a linear correlation with the clinical severity index.