螺旋CT灌注参数联合血清sFlt-1、B7-H3、鸢尾素在急性胰腺炎患者病情评估中的应用价值

目的探讨螺旋CT灌注参数联合血清可溶性血管内皮细胞生长因子受体-1(sFlt-1)、协同刺激分子B7家族3(B7-H3)、鸢尾素在急性胰腺炎(AP)患者病情评估中的应用价值。方法选取2017年1月至2020年1月我院102例AP患者作为观察组,其中轻症62例,重症40例。另选取同期来我院健康体检者102例作为对照组。比较两组、不同病情程度螺旋CT灌注参数血流量(BF)、血流容积(BV)、平均通过时间(MTT)]、血清sFlt-1、B7-H3、鸢尾素水平,分析螺旋CT参数、血清各指标水平与常规诊断标志物C反应蛋白(CRP)、降钙素原(PCT)]相关性及对AP患者病情程度的评估价值,并分析AP患者螺旋CT参数与血清各指标水平相关性。结果(1)观察组BF、BV、鸢尾素水平低于对照组,sFlt-1、B7-H3高于对照组(P<0.05);(2)AP患者BF、BV、鸢尾素水平与PCT、CRP水平呈负相关性,sFlt-1、B7-H3与PCT、CRP水平呈正相关性(P<0.05);(3)重症患者BF、BV、鸢尾素水平低于轻症患者,sFlt-1、B7-H3水平高于轻症患者(P<0.05);(4)BF、BV、MTT、鸢尾素、sFlt-1、B7-H3联合评估AP患者病情程度的曲线下面积(AUC)(0.899)>BV(0.814)>BF(0.806)>MTT(0.771)>血清sFlt-1(0.727)>血清B7-H3(0.709)>血清鸢尾素(0.680),敏感度为85.00%,特异性为88.71%;(5)AP患者螺旋CT参数BF、BV与血清B7-H3、sFlt-1水平呈负相关性,与血清鸢尾素呈正相关性(P<0.05)。结论螺旋CT灌注参数BF、BV、血清鸢尾素、sFlt-1、B7-H3在AP患者中呈异常表达,并与病情程度存在一定相关性。因此,联合螺旋CT灌注参数、血清sFlt-1、B7-H3、鸢尾素有望成为评估AP患者病情程度的有效手段。

Application Value of Perfusion Parameters of Spiral CT Combined with Serum sFlt-1,B7-H3 and Irigenin in the Evaluation of Patients with Acute Pancreatitis

Objective To investigate the application value of spiral CT perfusion parameters combined with serum soluble vascular endothelial cell growth factor receptor-1(sFlt-1),co-stimulatory molecule B7 family 3(B7-H3),and irigenin in the assessment of patients with acute pancreatitis(AP).Methods From January 2017 to January 2020,102 patients with AP in our hospital were selected as the observation group,of which 62 were mild and 40 were severe.Another 102 healthy people who came to our hospital during the same period were selected as the control group.Compa red the spiral CT perfusion parametersblood flow(BF),blood flow volume(BV),mean tra nsit time(MTT)],serum sFlt-1,B7-H3,and irigenin levels in the two groups and different disease levels,analyzed the correlation between spiral CT parameters,serum levels and conventional diagnostic markersC-reactive protein(CRP),procalcitonin(PCT)],and the evaluation value of the degree of disease in patients with AP,and the correlation between spiral CT parameters and serum indexes in patients with AP was analyzed.Results(1)The levels of BF,BV and irigenin in the observation group were lower than those in the control group,and sFlt-1 and B7-H3 were higher than those in the control group(P<0.05);(2)The levels of BF,BV,and irigenin in AP patients were negatively correlated with PCT and CRP levels,and sFlt-1,B7-H3 were positively correlated with PCT and CRP levels(P<0.05);(3)The levels of BF,BV and irigenin in severe patients were lower than those in mild patients,and the levels of sF1 t-1 and B7-H3 were higher than those in mild patients(P<0.05);(4)Area under the curve(AUC)of BF,BV,MTT,irisin,sFlt-1,B7-H3 combined assessment of the severity of AP patients(0.899)>BV(0.814)>BF(0.806)>MTT(0.771)>serum sFlt-1(0.727)>serum B7-H3(0.709)>serum irigenin(0.680),the sensitivity was 85.00%,and the specificity was 88.71%;(5)Spiral CT parameters BF and BV in AP patients were negatively correlated with serum B7-H3 and sFly-1 levels,and positively correlated with serum irigenin(P<0.05).Conclusion Spiral CT perfusion pa ra meters BF,BV,serum irisin,sFlt-1,B7-H3 a re abnormally expressed in patients with AP,and there is a specific correlation with the degree of disease.Therefore,combined spiral CT perfusion parameters,serum sFlt-1,B7-H3,and irigenin are expected to be effective means for assessing the extent of the disease in patients with AP.