Chen Yizhe, Ke Lu, Meng Lei, Yang Qi, Tong Zhihui, Pan Yiyuan, Li Weiqin, Li Jieshou
Surgical Intensive Care Unit (SICU), Department of General Surgery, Jinling Hospital, Medical School of Nanjing University, No.305 Zhongshan East Road, Nanjing, China.
Surgical Intensive Care Unit (SICU), Department of General Surgery, Jinling Hospital, Medical School of Nanjing University, No.305 Zhongshan East Road, Nanjing, China.
Pancreatology. 2017 Jan-Feb;17(1):45-50. doi: 10.1016/j.pan.2016.12.005. Epub 2016 Dec 15.
Endothelial injury is believed to play an important role in the evolution of pancreatic microcirculatory dysfunction and pancreatic necrosis (PN) in patients with acute pancreatitis (AP). The aim of this study was to investigate the role of three endothelial markers (von Willebrand factor, vWF; E-selectin; endothelial protein C receptor, EPCR) in the early phase of AP, especially the relationship between endothelial markers and PN.
From March 2015 to March 2016, 57 AP patients admitted within 72 h of symptom onset in our hospital were included for this study. Blood samples were taken on admission and the clinical characteristics and outcomes of these patients were recorded. The levels of vWF, E-selectin and EPCR were measured using ELISA for analysis and compared with other severity markers of AP.
All the three markers were significantly different in healthy control, mild, moderate and severe AP patients. Moreover, the endothelial markers, especially vWF, also showed significant difference in patients with different extent of PN, as well as those with or without MODS. Additionally, the levels of endothelial markers correlated well with other commonly used markers of AP severity.
Elevated endothelium-related mediators (vWF, E-selectin and EPCR) appear to participate in the development of PN and may be a potential indicator of overall prognosis. Our results may help clinicians better understand the pathophysiological process of the development of PN.
内皮损伤被认为在急性胰腺炎(AP)患者胰腺微循环功能障碍及胰腺坏死(PN)的进展中起重要作用。本研究旨在探讨三种内皮标志物(血管性血友病因子,vWF;E-选择素;内皮蛋白C受体,EPCR)在AP早期的作用,尤其是内皮标志物与PN之间的关系。
2015年3月至2016年3月,纳入我院症状发作72小时内入院的57例AP患者进行本研究。入院时采集血样,并记录这些患者的临床特征和结局。采用酶联免疫吸附测定法(ELISA)检测vWF、E-选择素和EPCR水平进行分析,并与AP的其他严重程度标志物进行比较。
健康对照、轻度、中度和重度AP患者的所有三种标志物均有显著差异。此外,内皮标志物,尤其是vWF,在不同PN程度以及有无多器官功能障碍综合征(MODS)的患者中也有显著差异。此外,内皮标志物水平与AP严重程度的其他常用标志物密切相关。
内皮相关介质(vWF、E-选择素和EPCR)升高似乎参与了PN的发生发展,可能是总体预后的潜在指标。我们的结果可能有助于临床医生更好地理解PN发生发展的病理生理过程。