TREM-1、H_2S联合ACE2检测对重症急性胰腺炎预后的评估价值

目的研究髓样细胞触发受体-1(TREM-1)、硫化氢(H₂S)联合血管紧张素转化酶2(ACE2)检测对重症急性胰腺炎预后的评估价值。方法选取2017年6月至2019年6月本院收治的58例重症急性胰腺炎患者作为研究组,按照治疗结局分为死亡组(n=18)和生存组(n=40),选取45例同期于本院接受健康体检结果正常者作为对照组。比较各组间TREM-1、H₂S及ACE2表达水平差异,采用Logistic回归分析影响重症急性胰腺炎患者预后生存的危险因素,采用ROC曲线分析TREM-1、H₂S、ACE2单项及联合检测水平对重症急性胰腺炎预后的预测价值。结果研究组TREM-1、H₂S及ACE2水平均高于对照组,差异具有统计学意义(P<0.05)。肺脏衰竭、心血管系统衰竭、APACHEⅡ、TREM-1、H₂S及ACE2水平为影响重症急性胰腺炎患者预后生存的多因素(P<0.05)。TREM-1、H₂S、ACE2评分及三者联合曲线下面积分别为0.839、0.789、0.763、0.963,各指标曲线下面积以联合检测最大。结论TREM-1、H₂S及ACE2水平在重症急性胰腺炎患者中显著升高,联合三者检测可作为评估患者预后生存的有效手段,临床上可检测其水平并及时进行干预,进而提高生存率。

The value of TREM?1,H2S combined with ACE2 in the prognosis of severe acute pancre?atitis

Objective To study the value of triggering receptor expressed on myeloid cells 1(TREM?1),hydrogen sulfide(H₂S)combined with angiotensin converting enzyme 2(ACE2)in estimating the prognosis of severe acute pancreatitis.Methods 58 patients with severe acute pancreatitis admitted to this hos?pital from June 2017 to June 2019 were selected as the study group,and the patients were divided into the death group(n=18)and the survival group(n=40)according to the treatment outcome.45 people with normal physi?cal examination results in our hospital during the same period were selected as the control group.The differences in the expression levels of TREM?1,H₂S and ACE2 between the groups were compared.Logistic regression was used to analyze the risk factors that affect the prognosis of patients with severe acute pancreatitis.The ROC curve was used to analyze the predictive value of TREM?1,H₂S and ACE2 individual or three combined detec?tion for the prognosis of patients with severe acute pancreatitis.Results The levels of TREM?1,H₂S and ACE2 in the study group were higher than those in the control group,and the difference was statistically signifi?cant(P<0.05).Pulmonary failure,cardiovascular system failure,APACHEⅡ,TREM?1,H₂S and ACE2 lev?els are multiple factors affecting the prognosis of patients with severe acute pancreatitis(P<0.05).The areas un?der the TREM?1,H₂S,ACE2 curves and the three combined curves were 0.839,0.789,0.763,and 0.963,respectively.The area under the curve of the three combined detection was the largest.Conclusion The levels of TREM?1,H₂S,and ACE2 significantly increased in patients with severe acute pancreatitis.The combined detec?tion of the three can be used as an effective means to assess the prognosis of patients.Clinically,their levels can be detected and timely interventions can be performed to improve the survival rate.