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急性胰腺炎早期血清中性粒细胞明胶酶相关脂质运载蛋白的测定

Determination of serum neutrophil gelatinase-associated lipocalin at the early stage of acute pancreatitis.

作者信息

Sporek Mateusz, Dumnicka Paulina, Gala-Błądzińska Agnieszka, Mazur-Laskowska Małgorzata, Walocha Jerzy, Ceranowicz Piotr, Warzecha Zygmunt, Dembiński Artur, Kuźniewski Marek, Olszanecki Rafał, Kuśnierz-Cabala Beata

机构信息

Department of Anatomy, Jagiellonian University Medical College, Kraków; Surgery Department, District Hospital, Sucha Beskidzka, Poland.

Department of Diagnostics, Chair of Clinical Biochemistry, Jagiellonian University Medical College, Kraków, Poland.

出版信息

Folia Med Cracov. 2016;56(2):5-16.

Abstract

AIM

e aim of the study was to assess the diagnostic value of serum concentrations of neutrophil gelatinase-associated lipocalin (sNGAL) for the determination of the severity of acute pancreatitis (AP) at the early stage of the disease.

MATERIALS AND METHOD

The study group consisted of 65 patients(34 men and 31 women),aged 62.2 ± 16.0, admitted to the Surgery Department of the District Hospital in Sucha Beskidzka, Poland, with the diagnosis of AP according to the revised Atlanta classification (2012). sNGAL was measured with ELISA at 24, 48 and 72 hours following the onset of AP symptoms. The correlations were analyzed between sNGAL and clinical, as well as laboratory parameters, used for the assessment of AP severity.

RESULTS

Severe AP was associated with higher sNGAL at 24, 48 and 72 hours, while moderately severe AP was associated with higher sNGAL at 48 and 72 hours as compared to mild disease. The BISAP score ≥3 during the first 24 hours of hospital stay, and the duration of hospital stay were significantly correlated with sNGAL. Also, sNGAL positively correlated with white blood cells, C-reactive protein and fibrinogen and negatively with albumin throughout the study. The diagnostic accuracy of sNGAL for the differentiation between mild AP and more severe disease was 75%, 77% and 85% at 24, 48 and 72 hours, respectively.

CONCLUSIONS

Serum NGAL concentrations are associated with inflammatory markers, BISAP score and the severity of AP. sNGAL may serve as an additional prognostic biomarker in the early assessment of AP severity.

摘要

目的

本研究旨在评估血清中性粒细胞明胶酶相关脂质运载蛋白(sNGAL)浓度在急性胰腺炎(AP)疾病早期确定其严重程度方面的诊断价值。

材料与方法

研究组由65例患者(34例男性和31例女性)组成,年龄62.2±16.0岁,因AP诊断入住波兰苏哈贝斯基德卡地区医院外科,诊断依据为修订的亚特兰大分类法(2012年)。在AP症状发作后24、48和72小时用酶联免疫吸附测定法(ELISA)测量sNGAL。分析sNGAL与用于评估AP严重程度的临床及实验室参数之间的相关性。

结果

与轻症相比,重症AP在24、48和72小时时sNGAL较高,中度重症AP在48和72小时时sNGAL较高。住院首日24小时内BISAP评分≥3以及住院时间与sNGAL显著相关。此外,在整个研究过程中,sNGAL与白细胞、C反应蛋白和纤维蛋白原呈正相关,与白蛋白呈负相关。sNGAL区分轻症AP和重症疾病的诊断准确率在24、48和72小时时分别为75%、77%和85%。

结论

血清NGAL浓度与炎症标志物、BISAP评分及AP严重程度相关。sNGAL可作为AP严重程度早期评估中的一种额外预后生物标志物。

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