Long Ding, Wang Yujun, Wang Hui, Wu Xiaoling, Yu Li
From the Intensive Care Unit, The Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Pancreas. 2019 Mar;48(3):335-342. doi: 10.1097/MPA.0000000000001247.
The aim of the study was to investigate the correlation of serum and ascitic fluid soluble form urokinase plasminogen activator receptor (suPAR) levels with patients' complications, disease severity, inflammatory markers, and prognosis in patients with severe acute pancreatitis (SAP).
Fifty patients with SAP, 47 patients with mild acute pancreatitis, and 50 healthy controls were enrolled. Serum samples were obtained from all participants after enrollment; meanwhile, ascitic fluid samples were collected from 20 patients with SAP who developed ascites. Serum and ascitic fluid suPAR levels were determined by enzyme-linked immunosorbent assay.
Serum suPAR level was greatly elevated in patients with SAP than patients with mild acute pancreatitis and healthy controls. Receiver operating characteristic curve showed that serum suPAR presented with good value in predicting risk of pancreatic necrosis, pancreatic infection, and multiple organ dysfunction syndrome, whereas serum suPAR did not predict mortality. Serum suPAR level was also positively correlated with Acute Physiology and Chronic Health Evaluation II score, Balthazar index, and Sequential Organ Failure Assessment score. As to ascitic fluid suPAR, it was positively correlated with serum suPAR level, Acute Physiology and Chronic Health Evaluation II score, Sequential Organ Failure Assessment score, risk of pancreatic infection, and multiple organ dysfunction syndrome.
Serum and ascetic fluid suPAR levels could be served as markers for disease severity and risk of severe complications in patients with SAP.
本研究旨在探讨血清和腹水可溶性尿激酶型纤溶酶原激活物受体(suPAR)水平与重症急性胰腺炎(SAP)患者并发症、疾病严重程度、炎症标志物及预后的相关性。
纳入50例SAP患者、47例轻症急性胰腺炎患者及50例健康对照者。入选后采集所有参与者的血清样本;同时,收集20例并发腹水的SAP患者的腹水样本。采用酶联免疫吸附测定法测定血清和腹水suPAR水平。
SAP患者血清suPAR水平显著高于轻症急性胰腺炎患者和健康对照者。受试者工作特征曲线显示,血清suPAR在预测胰腺坏死、胰腺感染及多器官功能障碍综合征风险方面具有良好价值,而血清suPAR不能预测死亡率。血清suPAR水平还与急性生理与慢性健康状况评分系统II评分、巴尔萨泽指数及序贯器官衰竭评估评分呈正相关。至于腹水suPAR,其与血清suPAR水平、急性生理与慢性健康状况评分系统II评分、序贯器官衰竭评估评分、胰腺感染风险及多器官功能障碍综合征呈正相关。
血清和腹水suPAR水平可作为SAP患者疾病严重程度及严重并发症风险的标志物。