Pancreatic Center, Department of Gastroenterology, Affiliated Hospital of Yangzhou University, Yangzhou University, Yangzhou, Jiangsu, China.
Institute of Gastroenterology, Affiliated Hospital of Yangzhou University, Yangzhou University, Yangzhou, Jiangsu, China.
BMC Gastroenterol. 2020 Nov 20;20(1):393. doi: 10.1186/s12876-020-01521-7.
To investigate the value of serum hydroxybutyrate dehydrogenase (HBDH) level, an isozyme of lactate dehydrogenase, in evaluating the severity of acute pancreatitis (AP).
Patients diagnosed with AP from January 2013 to December 2018 were included in this retrospective study. Patients were divided into the normal serum HBDH levels group (n-HBDH group) and the high serum HBDH levels group (h-HBDH group) according to the criteria HBDH ≥ 182 U/L after admission. The demographic parameters, laboratory data and the severity of AP in the two groups were compared. The receiver operating curve (ROC) was used to evaluate the efficacy of serum HBDH in predicting persistent organ failure and systemic inflammatory response syndrome (SIRS).
A total of 260 AP patients were enrolled, including 176 cases in the n-HBDH group and 84 cases in the h-HBDH group. The incidence of SIRS and organ failure in the h-HBDH group were significantly higher than those in n-HBDH group (both P < 0.001). In addition, the HBDH level was significantly decreased in 110 patients who were re-measured after AP treatment. The serum HBDH levels were positively correlated with Atlanta classification, Ranson score, and BISAP score (all P < 0.05). ROC analysis showed that a serum HBDH cut-off point of 195.0 U/L had optimal predictive value for the development of persistent organ failure (AUC = 0.778) and 166.5 U/L for the development of SIRS (AUC = 0.724).
The elevated serum HBDH in early stage of AP is closely related to the adverse prognosis of AP patients, which can be used as a potential early biomarker for predicting the severity of AP.
探讨血清羟丁酸脱氢酶（HBDH）水平，即乳酸脱氢酶同工酶，在评估急性胰腺炎（AP）严重程度中的价值。
本回顾性研究纳入了 2013 年 1 月至 2018 年 12 月期间诊断为 AP 的患者。根据入院后 HBDH≥182 U/L 的标准，将患者分为血清 HBDH 水平正常组（n-HBDH 组）和血清 HBDH 水平升高组（h-HBDH 组）。比较两组患者的一般资料、实验室数据及 AP 严重程度。采用受试者工作特征曲线（ROC）评估血清 HBDH 预测持续性器官衰竭和全身炎症反应综合征（SIRS）的效能。
共纳入 260 例 AP 患者，其中 n-HBDH 组 176 例，h-HBDH 组 84 例。h-HBDH 组 SIRS 和器官衰竭的发生率明显高于 n-HBDH 组（均 P<0.001）。此外，110 例 AP 患者经治疗后复查 HBDH 水平降低。血清 HBDH 水平与亚特兰大分类、Ranson 评分和 BISAP 评分均呈正相关（均 P<0.05）。ROC 分析显示，血清 HBDH 截断值为 195.0 U/L 时对持续性器官衰竭的发生具有最佳预测价值（AUC=0.778），截断值为 166.5 U/L 时对 SIRS 的发生具有最佳预测价值（AUC=0.724）。
AP 早期血清 HBDH 升高与 AP 患者不良预后密切相关，可作为预测 AP 严重程度的潜在早期标志物。
