脂肪因子在评估急性胰腺炎预后价值中的探讨

目的脂肪因子在急性胰腺炎发病机制中的作用及对预后评估的价值。方法重型急性胰腺炎(SAP)患者14例。轻型急性胰腺炎(MAP)患者62例,检测两组血清中抵抗素、瘦素、脂联素、C反应蛋白和APACHEⅡ评分。结果抵抗素,瘦素及C反应蛋白在SAP组、MAP组之间存在显著差异(P0.05)。SAP组在APACEII评分和MODS患病率明显高于MAP组。MAP组抵抗素和瘦素水平较高的8例发展为重症胰腺炎,在入院24 h并未见CRP的明显增高,其中3例出现多系统器官衰竭。结论监测急性胰腺炎患者血清抵抗素、瘦素、CRP对评估急性胰腺炎的严重程度、早期预警MODS和评估患者预后方面有一定的临床应用价值,脂肪细胞因子的改变能够在CRP并未发生明显变化前出现,早期提示轻型胰腺炎的恶化。

Evaluation of the Adipocytokine in the prediction of severity in acute pancreatitis

Objective To investigate the adipocytokine in acute pancreatitis in the value of prognosis.Methods severe acute pancreatitis（SAP） of 14 patients.Mild acute pancreatitis（MAP） 62 patients were detected in serum resistin,leptin,adiponectin,C-reactive protein and APACHE II score.Results Resistin,leptin and C-reactive protein in the SAP group,MAP group was significantly different between groups（P0.05）.SAP Group APACEII score and MODS was significantly higher than the prevalence of MAP group.MAP group with higher levels of resistin and leptin,8 patients developed severe pancreatitis,24 h after admission and no apparent increase in CRP,including 3 cases of multiple system organ failure.Conclusion Monitoring serum resistin,leptin,CRP in patients with acute pancreatitis to assess the severity of acute pancreatitis,may be early warning and assessment of prognosis of MODS,changes in adipocytokine is not obvious to the CRP before the change occurs,the early increase prompted the deterioration of pancreatitis.