急性胰腺炎患者血清降钙素原和协同刺激分子B7家族及可溶性细胞间黏附分子-1水平变化及意义

目的探讨急性胰腺炎患者血清降钙素原(procalcitonin,PCT)、协同刺激分子B7家族(serum costimulatory molecule B7family,B7-H3)、可溶性细胞间黏附分子-1(soluble intercellular adhesion molecule-1,sICAM-1)水平变化,及其在急性胰腺炎病情严重程度评估中的价值。方法 90例重症急性胰腺炎(severe acute pancreatitis,SAP)患者为SAP组,90例轻症急性胰腺炎(mild acute pancreatitis,MAP)患者为MAP组,100例体检健康者为对照组。检测3组血清PCT、B7-H3、sICAM-1水平;对SAP组、MAP组行急性生理与慢性健康评估系统(Acute Physiology and Chronic Health EvaluationⅡ,APACHEⅡ)和急性胰腺炎RANSON评分评定病情严重程度;Pearson法分析血清PCT、B7-H3、sICAM-1与APACHEⅡ、RANSON评分的相关性。结果 SAP组、MAP组血清PCT(9.9±3.2)、(5.6±2.2)μg/L]、B7-H3(181.7±26.6)、(67.2±10.2)ng/L]、sICAM-1(1 036.9±68.4)、(448.6±50.2)g/L]水平均高于对照组(1.2±0.4)μg/L、(53.0±2.7)ng/L、(29.8±16.5)g/L](P0.05),且SAP组高于MAP组(P0.05);MAP组APACHEⅡ评分(7.8±1.3)分]、RANSON评分(2.7±1.0)分]低于SAP组(13.0±2.6)、(5.3±1.8)分](P0.05);Pearson相关分析结果显示,SAP组APACHEⅡ、RANSON评分与血清PCT(r=0.761,P=0.017;r=0.751,P=0.013)、B7-H3(r=0.710,P=0.016;r=0.701,P=0.012)、sICAM-1(r=0.645,P=0.010;r=0.668,P=0.007)均呈正相关;MAP组患者APACHEⅡ、RANSON评分与血清PCT(r=0.793,P=0.015;r=0.775,P=0.010)、B7-H3(r=0.738,P=0.014;r=0.730,P=0.013)、sICAM-1(r=0.730,P=0.011;r=0.680,P=0.012)均呈正相关。结论急性胰腺炎患者血清PCT、B7-H3、sICAM-1水平增高程度与APACHEⅡ、RANSON评分呈正相关,血清PCT、B7-H3、sICAM-1可作为判断急性胰腺炎病情严重程度的指标。