Kuśnierz-Cabala Beata, Gurda-Duda Anna, Panek Józefa, Fedak Danuta, Dumnicka Paulina, Solnica Bogdan, Kulig Jan
Department of Diagnostics, Jagiellonian University Collegium Medicum, Krakow, Poland.
Clin Lab. 2010;56(5-6):191-5.
Acute pancreatitis (AP) is a mild and self-limiting disease in most patients, but necrotizing pancreatitis develops in up to 20 - 30% of the cases. Early recognition of severe AP has been considered as a key determinant of successful therapy. The aim of this study was to evaluate the clinical value of fetuin A as the new predictor of complications and fatal outcome during acute pancreatitis (AP).
The study included 40 patients with AP of diverse severity (28 mild, 12 severe), assessed during the early phase of AP (1st - 7th day of hospitalization). Fetuin A level was measured by ELISA kit (BioVendor).
Median serum fetuin A concentrations had a tendency to decrease during examination from 0,371 g/L at admission to 0,288 g/L on the 7th day of hospitalization. In each of 7 days of observation, correlation between the increase in fetuin A and the absolute number of RBC was found (R = 0,34: 1st day R = 0,35: 3rd day, p < 0,05; R = 0,57: 5th day, p < 0,001; R = 0,65: 7th day, p < 0,01). Additionally, we observed the reverse relationship between the decrease in fetuin A and the increase in some inflammatory markers (IL-6: R = -0,61, p < 0,0001; SAA: R = -0,58, p < 0,001; HGF: R = -0,60, p < 0,01; PCT: R = -0,475, p < 0,01). The strongest positive correlation was noticed on the 5th day of hospitalization between decreased levels of fetuin A and albumin (R = 0,83; p < 0,0001).
Fetuin A level monitoring is potentially a new marker for non-invasive and accurate prediction status for the hospitalization of patients with AP similar to other negative acute phase proteins like albumin.
急性胰腺炎(AP)在大多数患者中是一种轻度的自限性疾病,但高达20%-30%的病例会发展为坏死性胰腺炎。早期识别重症急性胰腺炎被认为是成功治疗的关键决定因素。本研究的目的是评估胎球蛋白A作为急性胰腺炎(AP)并发症和致命结局新预测指标的临床价值。
本研究纳入40例不同严重程度的急性胰腺炎患者(28例轻度,12例重度),在急性胰腺炎早期(住院第1-7天)进行评估。采用ELISA试剂盒(BioVendor)检测胎球蛋白A水平。
在检查期间,血清胎球蛋白A浓度中位数有下降趋势,从入院时的0.371g/L降至住院第7天的0.288g/L。在观察的7天中,每天均发现胎球蛋白A升高与红细胞绝对数量之间存在相关性(第1天R=0.35,第3天R=0.34,p<0.05;第5天R=0.57,p<0.001;第7天R=0.65,p<0.01)。此外,我们观察到胎球蛋白A下降与一些炎症标志物升高之间呈负相关(IL-6:R=-0.61,p<0.0001;SAA:R=-0.58,p<0.001;HGF:R=-0.60,p<0.01;PCT:R=-0.475,p<0.01)。住院第5天,胎球蛋白A水平下降与白蛋白之间的正相关性最强(R=0.83;p<0.0001)。
与白蛋白等其他负急性期蛋白类似,监测胎球蛋白A水平可能是一种用于非侵入性准确预测急性胰腺炎患者住院状态的新标志物。