Zhao Bing, Chen Ying, Sun Wen Wu, Chen Wei Wei, Ma Li, Yang Zhi Tao, Huang Jun, Chen Er Zhen, Fei Jian, Mao En Qiang
Department of Emergency Intensive Care Unit, Shanghai, China.
Shanghai Key Laboratory of Hypertension, Shanghai Institute of Hypertension, Shanghai, China.
J Dig Dis. 2016 Jul;17(7):475-82. doi: 10.1111/1751-2980.12364.
To assess whether serum levels of S100A12 and soluble receptor for advanced glycation end products (sRAGE) could predict the severity of acute pancreatitis (AP).
We conducted a non-interventional pilot study, including 74 AP patients and 28 healthy volunteers serving as controls. AP patients were further divided into the mild (MAP, n = 22), moderately severe (MSAP, n = 30) and severe (SAP, n = 22) groups. Peripheral blood samples were collected within 72 h after the onset of AP for the determination of S100A12, sRAGE and C-reactive protein (CRP) levels. The acute physiology and chronic health evaluation II (APACHE II) score, Balthazar computed tomography severity index (CTSI) were calculated at admission.
S100A12 and sRAGE levels in SAP patient were significantly higher than in controls, MAP and MSAP patients. The receiver operating characteristic (ROC) curve analysis demonstrated the predictive ability of S100A12 [sensitivity 91%, specificity 81%, the area under the ROC curve AUROC 0.9047] and sRAGE (sensitivity 57%, specificity 100%, AUROC 0.8304) for evaluating the severity of AP. S100A12 and sRAGE were correlated with APACHE II and CTSI but not with CRP. This combination of new and traditional indicators had higher accuracy than traditional indicators alone. Specifically, S100A12 and sRAGE were positively correlated with the type of organ failure (respiratory and renal failure) and might distinguish transient from persistent organ failure at admission.
S100A12 and sRAGE could be used as efficient biomarkers for the early identification of SAP.
评估血清S100A12水平和晚期糖基化终产物可溶性受体(sRAGE)能否预测急性胰腺炎(AP)的严重程度。
我们进行了一项非干预性初步研究,纳入74例AP患者和28名健康志愿者作为对照。AP患者进一步分为轻症(MAP,n = 22)、中重症(MSAP,n = 30)和重症(SAP,n = 22)组。在AP发病后72小时内采集外周血样本,测定S100A12、sRAGE和C反应蛋白(CRP)水平。入院时计算急性生理与慢性健康状况评分系统II(APACHE II)评分、巴尔萨泽计算机断层扫描严重程度指数(CTSI)。
SAP患者的S100A12和sRAGE水平显著高于对照组、MAP和MSAP患者。受试者工作特征(ROC)曲线分析显示S100A12[灵敏度91%,特异性81%,ROC曲线下面积(AUROC)0.9047]和sRAGE(灵敏度57%,特异性100%,AUROC 0.8304)对评估AP严重程度具有预测能力。S100A12和sRAGE与APACHE II和CTSI相关,但与CRP无关。这种新指标与传统指标的组合比单独使用传统指标具有更高的准确性。具体而言,S100A12和sRAGE与器官衰竭类型(呼吸和肾衰竭)呈正相关,且可能在入院时区分短暂性和持续性器官衰竭。
S100A12和sRAGE可作为早期识别SAP的有效生物标志物。