中性粒细胞明胶酶相关脂质运载蛋白在急性胰腺炎中的应用

doi:10.3969/j.issn.1673-8640.2020.05.005

摘要/Abstract

摘要：

目的探讨血清中性粒细胞明胶酶相关脂质运载蛋白（NGAL）在急性胰腺炎（AP）中的应用价值。方法选取临床上被确诊为AP的患者74例作为AP组[轻度急性胰腺炎（MAP）组（34例）、重症急性胰腺炎（SAP）组（40例）],以20名体检健康者作为正常对照组。检测所有研究对象血清中NGAL、血尿素氮（BUN）、肌酐（Cr）、C反应蛋白（CRP）、淀粉酶（AMY）水平,采用受试者工作特征（ROC）曲线评价血清NGAL、AMY诊断AP的价值。结果 SAP组和MAP组血清NGAL、AMY、CRP水平均高于正常对照组（P<0.05）;SAP组血清NGAL、CRP水平高于MAP组（P<0.05）,2个组之间血清AMY水平差异无统计学意义（P>0.05）;SAP组、MAP组和正常对照组之间BUN、Cr水平差异均无统计学意义（P>0.05）。ROC曲线分析结果显示,NGAL、AMY诊断AP的ROC曲线下面积（AUC）分别为0.722、0.784,最佳临界值分别为240 ng/mL、250 U/L,敏感性分别为90.0%、83.3%,特异性分别为55.4%、63.9%。结论血清NGAL检测对AP的辅助诊断有一定价值,且在一定程度上可反映AP的严重程度。

关键词: 中性粒细胞明胶酶相关脂质运载蛋白, 淀粉酶, 急性胰腺炎

Abstract:

Objective To investigate the clinical application of neutrophil gelatinase-associated lipocalin（NGAL） in acute pancreatitis（AP）. Methods A total of 74 AP patients were enrolled,and there were 34 cases of mild acute pancreatitis（MAP） and 40 cases of severe acute pancreatitis（SAP）. A total of 20 healthy subjects were enrolled as healthy control group. Serum levels of NGAL,blood urea nitrogen（BUN）,creatinine（Cr）,C-reactive protein（CRP） and amylase（AMY） were determined. Using receiver operating characteristic（ROC） curve,the diagnostic performance of serum NGAL and AMY for AP was evaluated. Results Compared with SAP and MAP groups,serum NGAL,AMY and CRP levels were lower in healthy control group（P<0.05）,and NGAL and CRP levels in SAP group were higher than those in MAP group（P<0.05）. There was no statistical significance for AMY between the 2 groups（P>0.05）. BUN and Cr had no statistical significance among the 3 groups（P>0.05）. ROC curve analysis showed that the areas under curves（AUC） of NGAL and AMY for the diagnosis of AP were 0.722 and 0.784,the optimal cut-off values were 240 ng/mL and 250 U/L,the sensitivities were 90.0% and 83.3%,and the specificities were 55.4% and 63.9%,respectively. Conclusions Serum NGAL determination plays a role in the diagnosis of AP,which can reflect the degree of AP infection.

Key words: Neurtrophil gelatinase-associated lipocalin, Amylase, Acute pancreatitis

中图分类号:

R446.1

葛玲, 吴丽颖. 中性粒细胞明胶酶相关脂质运载蛋白在急性胰腺炎中的应用[J]. 检验医学, 2020, 35(5): 420-423.

GE Ling, WU Liying. Clinical application of neutrophil gelatinase-associated lipocalin in acute pancreatitis[J]. Laboratory Medicine, 2020, 35(5): 420-423.

图/表 2

参考文献 24

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组别	例数	NGAL/（ng/mL）	AMY/（U/L）	CRP/（mg/L）	BUN/（mmol/L）	Cr/（μmol/L）
正常对照组	20	123.5（110.8~145.3）	49.5（44.0~59.0）	0.9（0.6~1.1）	5.06±0.70	64.60±12.58
MAP组	34	208.0（179.0~256.0）^*	266.0（210.0~385.0）^*	21.9（6.0~66.1）^*	5.36±3.50	66.29±26.86
SAP组	40	378.0（257.0~621.0）^*#	271.5（162.5~422.5）^*	65.6（24.5~106.5）^*#	6.08±3.60	80.7±41.05
统计值		122.88	57.71	68.11	1.59	1.76
P值		0.00	0.00	0.00	0.15	0.11

组别	例数	NGAL/（ng/mL）	AMY/（U/L）	CRP/（mg/L）	BUN/（mmol/L）	Cr/（μmol/L）
正常对照组	20	123.5（110.8~145.3）	49.5（44.0~59.0）	0.9（0.6~1.1）	5.06±0.70	64.60±12.58
MAP组	34	208.0（179.0~256.0）^*	266.0（210.0~385.0）^*	21.9（6.0~66.1）^*	5.36±3.50	66.29±26.86
SAP组	40	378.0（257.0~621.0）^*#	271.5（162.5~422.5）^*	65.6（24.5~106.5）^*#	6.08±3.60	80.7±41.05
统计值		122.88	57.71	68.11	1.59	1.76
P值		0.00	0.00	0.00	0.15	0.11