血清ICAM-1、SIL-2R、IL-2水平对重症急性胰腺炎患者病情及预后评估的临床价值

目的探讨血清细胞间黏附分子-1(ICAM-1)、可溶性白介素2受体(SIL-2R)、白细胞介素-2(IL-2)水平对重症急性胰腺炎(AP)患者病情及预后评估的价值。方法回顾性收集2016年2月至2019年2月收治的重症AP 51例作为重症组,收集同期收治的轻症AP 40例作为轻症组,选取同期来医院体检且留存完整血样标本的30例作为对照组,酶联免疫吸附法(ELISA)测定血ICAM-1、SIL-2R、IL-2水平,并进行病情Ranson评分,分析三者与AP病情进展及重症AP预后的关系。结果轻症组、重症组入院时血清ICAM-1、SIL-2R水平高于对照组,IL-2水平低于对照组(P<0.05),重症组血清ICAM-1、SIL-2R水平高于轻症组,IL-2水平低于轻症组P<0.05);重症组入院时Ranson评分高于轻症组(P<0.05);死亡组血清ICAM-1、SIL-2R及Ranson评分均高于生存组,IL-2水平低于生存组(P<0.05);ICAM-1与SIL-2R、Ranson评分均呈正相关(r=0.784、0.560,P均<0.05),与IL-2呈负相关(r=-0.486,P<0.05),SIL-2R与Ranson评分呈正相关(r=0.688,P<0.05),与IL-2呈负相关(r=-0.567,P<0.05),IL-2与Ranson评分呈负相关(r=-0.523,P<0.05);ICAM-1>183.83ng/mL时,预测重症AP灵敏度、特异性分别为86.27%、92.50%;SIL-2R>45.75 pg/mL时预测重症AP灵敏度、特异性分别为88.24%、90.00%;IL-2<3.41 pg/mL时预测重症灵敏度、特异性分别为84.31%、90.00%。结论AP伴明显ICAM-1、SIL-2R表达上调,IL-2表达降低,三者均与AP病情进展有关,可作为预测重症AP发病及评估AP预后的依据。

The Clinical Value of Serum ICAM-1,SIL-2R and IL-2 Levels in Evaluating Condition and Prognosis of Patients with Severe Acute Pancreatitis

Objective To explore evaluation value of levels of serum intercellular adhesion molecule-1(ICAM-1),soluble interleukin-2 receptor(SIL-2R)and interleukin-2(IL-2)for condition and prognosis of patients with severe acute pancreatitis(AP).Methods A retrospective data collection was performed on 51 patients with severe AP who were admitted from February,2016 to February,2019,and they were enrolled as the severe group.40 patients with mild AP who were admitted during the same period were enrolled as the mild group.30 patients who underwent physical examinations during the same period were enrolled as the control group.The intact blood samples of patients in all three groups were retained.The contents of serum ICAM-1,SIL-2R and IL-2 were measured by enzyme-linked immunosorbent assay(ELISA).The Ranson scoring was conducted.The relationships between the levels of three markers and the progression,prognosis of severe AP were analyzed.Results At admission,contents of serum ICAM-1 and SIL-2R in the mild and severe group were higher than those in the control group,while IL-2 content was lower(P<0.05).The contents of serum ICAM-1 and SIL-2R in the severe group were higher than those in the mild group,while IL-2 content was lower(P<0.05).At admission,Ranson score in the severe group was higher than that in the mild group(P<0.05).The serum ICAM-1 and SIL-2R,as well as Ranson scores in the death group were higher than those in the survival group,while IL-2 content was lower(P<0.05).ICAM-1 was positively correlated with SIL-2R and Ranson score(r=0.784,0.560,P<0.05),while negatively correlated with IL-2(r=-0.486,P<0.05).SIL-2R was positively correlated with Ranson score(r=0.688,P<0.05),while negatively correlated with IL-2(r=-0.567,P<0.05).IL-2 was negatively correlated with Ranson score(r=-0.523,P<0.05).When ICAM-1 was greater than 183.83 ng/mL,the sensitivity and specificity of predicting severe AP were 86.27%and 92.50%,respectively.When SIL-2R was greater than 45.75 pg/mL,the sensitivity and specificity of predicting severe AP were 88.24%and 90.00%,respectively.When IL-2 was less than 3.41 pg/mL,the sensitivity and specificity of predicting severe AP were 84.31%and 90.00%,respectively.Conclusion AP is accompanied with significant up-regulation of ICAM-1 and SIL-2R expressions,and decrease of IL-2 expression.All three markers are associated with the progression of AP,which can be applied as the knowledge basis for predicting severe AP onset and assessing AP prognosis.