急性胆囊炎患者血浆β-防御素-3的检测及临床意义

目的:揭示急性胆囊炎患者血浆β-防御素-3浓度的变化,探讨其与急性胆囊炎患病危险性的相关性.方法:收集急性胆囊炎患者作为胆囊炎组,共82例,其中坏疽性胆囊炎15例,非坏疽性胆囊炎67例.收集同期健康体检者作为对照组,共50例.ELISA检测血浆β-防御素-3浓度.统计分析其与急性胆囊炎患病危险性的相关性.结果:t检验显示,胆囊炎组患者血浆β-防御素-3浓度(81.4±36.9)pg/ml显著低于对照组血浆β-防御素-3浓度(154.2±28.3)pg/ml(P<0.001),坏疽性胆囊炎患者血浆β-防御素-3浓度(64.2±24.1)pg/ml显著低于非坏疽性胆囊炎患者血浆β-防御素-3浓度(94.3±29.9)pg/ml(P<0.001).Logistic回归分析显示,血浆β-防御素-3浓度是罹患急性胆囊炎(OR=0.483,95%CI=0.298~0.709,P<0.01)和坏疽性胆囊炎(OR=0.426,95%CI=0.239~0.648 P<0.01)的独立危险因素.ROC曲线分析显示,血浆β-防御素-3浓度预测罹患急性胆囊炎(曲线下面积=0.824,95%CI=0.712~0.896,P<0.001)和坏疽性胆囊炎(曲线下面积=0.836,95%CI=0.723~0.904,P<0.001)有显著预测价值.结论:急性胆囊炎患者血浆β-防御素-3水平降低,可能是急性胆囊炎的危险因素.

Determination of Plasma Beta-defensin-3 Concentration in Patients with Acute Cholecystitis and its Clinical Significance

Objective To study the changes of plasma beta-defensin-3 level were determined in patients with acute cholecystitis and its correlation with disease was evaluated. Methods 82 consecutive patients with acute cholecystitis including 15 patients with acute gangrenous cholecystitis and 50 healthy controls were enrolled into this study. Plasma beta-defensin-3 concentration was measured by ELISA. Its correlation with disease was analyzed statistically. Results The plasma beta-defensin-3 level （81.4 ± 36.9 pg/ml） in patients with acute cholecystitis was significantly lower than that （ 154.2 ±28.3 pg/ml） in healthy controls（t = 8. 957, P 〈0.001 ） and the plasma beta-defensin-3 level （64.2 ± 24.1 pg/ml） in patients with acute gangrenous cholecystitis was significantly lower than that （94.3±29.9 pg/ml） in patients without acute gangrenous cholecystitis（t =9. 478, P 〈0.001 ）using t test. On a multivariate logistic regression, plasma beta-defensin-3 level was an independent variable predicting acute cholecystitis （ OR = 0. 483, 95% CI = 0.298 - 0. 709, P 〈 0.01 ） and acute gangrenous cholecystitis （ OR = 0.426, 95 % CI = 0.239 - 0. 648, P 〈 0.01 ）. A receiver operating characteristic curve identified that a plasma beta-defensin-3 level significantly predicted acute cholecystitis （ Area under curve = 0.824, 95% CI = 0.712 - 0.896, P 〈 0.001 ） and acute gangrenous ehalecystitis （ Area under curve = 0.836, 95% CI = 0.723 - 0.904, P 〈 0.001 ）. Conclusiorl Decreased beta-defensin-3 is found after acute cholecystitis and low beta-defensin-3 may be independently associated with acute cholecystitis.