Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea.
J Gastroenterol Hepatol. 2018 Feb;33(2):548-553. doi: 10.1111/jgh.13860.
Severe acute pancreatitis (SAP) has considerable mortality and morbidity rates. Although many indices have been developed to classify the severity of acute pancreatitis (AP), an optimal method for predicting SAP has not been identified. The ratio of apolipoprotein B to A-I (apoB/A-I) is associated with metabolic syndrome and inflammatory status. This study investigated the association between severity of AP and serum apoB/A-I ratio.
Patients with AP were prospectively enrolled at Yonsei University Wonju College of Medicine from March 2015 to August 2016. The severity of AP was assessed according to the revised Atlanta classification criteria (Atlanta 2012).
Of 191 patients with AP, 134 (70.2%) had mild AP, 42 (22%) had moderately severe AP, and 15 (7.9%) had SAP; apoB/A-I ratio was highest in patients with SAP (P = 0.001). The apoB/A-I ratio was positively correlated with Atlanta classification, computed tomography severity index, and Bedside index for severity of AP. The apoB/A-I ratio showed the highest predictive value for SAP in patients with AP compared with apolipoprotein B or apolipoprotein A-I alone.
Serum apoB/A-I ratio appears to have value for predicting SAP in patients with AP.
重症急性胰腺炎(SAP)具有相当高的死亡率和发病率。尽管已经开发了许多指数来对急性胰腺炎(AP)的严重程度进行分类,但尚未确定预测 SAP 的最佳方法。载脂蛋白 B 与载脂蛋白 A-I 的比值(apoB/A-I)与代谢综合征和炎症状态有关。本研究旨在探讨 AP 严重程度与血清 apoB/A-I 比值之间的关系。
2015 年 3 月至 2016 年 8 月,延世大学汶州医学院前瞻性纳入了 AP 患者。AP 的严重程度根据修订后的亚特兰大分类标准(Atlanta 2012)进行评估。
在 191 例 AP 患者中,134 例(70.2%)为轻症 AP,42 例(22%)为中度重症 AP,15 例(7.9%)为 SAP;SAP 患者的 apoB/A-I 比值最高(P=0.001)。apoB/A-I 比值与亚特兰大分类、计算机断层扫描严重指数和床边 AP 严重程度指数呈正相关。与单独的载脂蛋白 B 或载脂蛋白 A-I 相比,apoB/A-I 比值在预测 AP 患者 SAP 方面具有最高的预测价值。
血清 apoB/A-I 比值似乎对预测 AP 患者的 SAP 具有价值。