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血清脂联素、网膜素及内脂素水平与急性胰腺炎严重程度的相关性分析

许新 陈章兴

引用本文:
Citation:

血清脂联素、网膜素及内脂素水平与急性胰腺炎严重程度的相关性分析

DOI: 10.12449/JCH240920
基金项目: 

厦门市卫生指导性项目 (3502Z20199063)

伦理学声明:本研究方案于2024年3月30日经由厦门大学附属成功医院伦理委员会审批,批号:73JYY2024137744。
利益冲突声明:本文不存在任何利益冲突。
作者贡献声明:许新负责课题设计,收集数据,资料分析,撰写论文及修改论文;陈章兴负责拟定写作思路,指导撰写文章并最后定稿。
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    通信作者:

    许新, xuxing19891031@126.com (ORCID: 0000-0002-2966-9459)

Correlation of the serum levels of adiponectin, omentin, and visfatin with the severity of acute pancreatitis

Research funding: 

Xiamen City Health Guidance Project (3502Z20199063)

More Information
  • 摘要:   目的  探讨血清脂联素、网膜素及内脂素水平与急性胰腺炎(AP)严重程度的相关性。  方法  收集2022年3月—2023年10月厦门大学附属成功医院收治的70例AP患者和35例对照组健康者的血液标本,采用酶联免疫吸附试验检测各组入院24 h内血清脂联素、网膜素及内脂素水平。计量资料组间比较采用方差分析,进一步两两比较采用LSD-t检验;计数资料组间比较采用χ2检验。各指标相关性用Pearson相关性分析,采用受试者工作特征曲线评估3项指标对重症急性胰腺炎(SAP)预测价值。  结果  AP组的血清网膜素及内脂素水平明显高于对照组(t值分别为5.51、9.41,P值均<0.01),随着病情的加重,内脂素水平逐渐升高(F=43.32,P<0.01),而网膜素随着病情的加重变化不明显(F=0.47,P>0.05)。AP组的脂联素水平低于对照组(t=-14.47,P<0.01),且随着病情的加重而逐渐下降(F=35.61,P<0.01)。血清内脂素水平与急性生理与慢性健康评分(APACHE-Ⅱ评分)正相关(r=0.547,P<0.01),脂联素水平与之负相关(r=-0.520,P<0.01),而网膜素与APACHE-Ⅱ评分关系不明显(r=0.007,P>0.05)。3项指标预测SAP的受试者工作特征曲线下面积(AUC)分别为0.893、0.570及0.829,将AUC>0.7的脂联素及内脂素两组联合检测时SAP的AUC为0.953,敏感度0.900,特异度0.933。  结论  血清脂联素及内脂素水平与AP的严重程度密切相关,对预测SAP具有重要的临床意义,两者联合检测具有更高的价值,但网膜素水平与AP的严重程度是否相关尚需进一步研究。

     

  • 图  1  血清脂联素水平与APACHE-Ⅱ评分的相关性

    Figure  1.  Correlation between serum adiponectin level and APACHE-Ⅱscore.

    图  2  血清网膜素水平与APACHE-Ⅱ评分的相关性

    Figure  2.  Correlation between serum omentin level and APACHE-Ⅱscore.

    图  3  血清内脂素水平与APACHE-Ⅱ评分的相关性

    Figure  3.  Correlation between serum visfatin level and APACHE-Ⅱ score.

    图  4  血清脂联素、网膜素及内脂素水平预测SAP的ROC曲线

    Figure  4.  The ROC curve of serum adiponectin, omentin and visfatin levels for predicting SAP

    表  1  两组患者血清脂联素、网膜素及内脂素水平比较

    Table  1.   Comparison of serum adiponectin, omentin and visfatin levels between two groups

    组别 例数 脂联素(μg/mL) 网膜素(ng/mL) 内脂素(μg/mL)
    AP组 70 9.19±2.67 31.12±8.27 8.60±1.95
    对照组 35 18.56±3.90 23.05±3.64 2.31±0.54
    t -14.47 5.51 9.41
    P <0.001 <0.001 <0.001
    下载: 导出CSV

    表  2  AP组不同严重程度患者血清脂联素、网膜素及内脂素水平比较

    Table  2.   Comparison of serum adiponectin, omentin and visfatin levels in AP patients with different severity

    组别 例数 脂联素(μg/mL)

    网膜素

    (ng/mL)

    内脂素(μg/mL)
    MAP组 35 10.34±1.88 31.55±7.05 7.35±1.39
    MSAP组 25 8.97±2.571) 30.83±9.40 9.50±1.291)
    SAP组 10 5.72±2.191)2) 30.38±9.95 10.75±1.961)2)
    F 35.61 0.47 43.32
    P <0.001 0.82 <0.001

    注:与MAP组比较,1)P<0.05;与MASP组比较,2)P<0.05。

    下载: 导出CSV

    表  3  血清脂联素、网膜素及内脂素预测SAP效能分析

    Table  3.   Analysis of the predictive efficacy of serum adiponectin, omentin and visfatin in SAP

    指标 最佳临界值 AUC P 敏感度 特异度 95%CI
    脂联素 6.85 μg/mL 0.893 <0.001 0.800 0.917 0.790~0.997
    网膜素 33.2 ng/mL 0.570 0.481 0.800 0.467 0.37~0.770
    内脂素 8.70 μg/mL 0.829 0.001 0.800 0.633 0.704~0.954
    脂联素+内脂素 - 0.953 <0.001 0.900 0.933 0.903~1.000
    下载: 导出CSV
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