α-黑色素细胞刺激素 胰蛋白酶原激活肽 白介素-6检测评估急性胰腺炎病情严重程度的价值

摘要

Objective To investigate the value of acute pancreatitis(AP) patients' peripheral blood alpha melanocyte stimulation hormone (α-MSH), trypsin peptide (TAP), interleukin 6 (IL-6) in evaluation of the severity of the patient condition.Methods A total of 97 patients with AP were selected in the Second Hospital of Anhui Medical Universityfrom June 2015to March 2016, and among them 56 patients were enrolled in mild group and 41 patients insevere group. The peripheral blood was collected in all patients on 1st, 3rd, 5th, 7th day of admission. Enzyme-linked immunosorbent assay was employed for quantitative determination of α-MSH, TAP, IL-6, and severe group was administered once APACHEⅡ and Ranson's score on admission.Results Compared with the mild group, the peripheral bloodα-MSH in the severe group was at a low level in one week, IL-6 was at a higher level, and the first three days of TAP were at a higher level, and the difference between thetwo groups was statistically significant (P<0.05). In the evaluation of disease severity, α-MSH the area under the curve was 0.848, Ranson score under the curve was 0.818, APACHE-II score under the curve was 0.789, TAP under the curve was 0.675, IL-6 under the curve was 0.693. α-MSH, and TAP and IL-6 combined under the curve was 0.906.Conclusion Peripheral bloodα-MSH, TAP, IL-6 levels have some clinical valuein predicting AP severity degree. The accuracy of α-MSH in evaluating the severity of the disease is higher than that of the TAP and IL-6. The combined use of the three in detection has higher accuracy.%目的 探讨急性胰腺炎(AP)患者外周血α-黑色素细胞刺激素(α-MSH)、胰蛋白酶原激活肽(TAP)、白介素-6(IL-6)检测评估AP严重程度的价值.方法 选择2015年6月至2016年3月安徽医科大学第二附属医院收治的97例AP患者,按AP严重程度分为轻症组(56例)和重症组(41例).所有患者入院后第1、3、5、7天抽取外周静脉血,采用酶联吸附法定量测定α-MSH、TAP、IL-6浓度水平,重症组患者入院时给予APACHEⅡ及Ranson评分.结果 与轻症组相比较,入院1周内重症组外周血α-MSH处于较低的水平,IL-6处于较高的水平,入院前3天重症组TAP水平处于较高水平,两组患者α-MSH、TAP、IL-6差异有统计学意义(P<0.05).在病情严重度评估方面,α-MSH的ROC曲线下面积为0.848,Ranson评分曲线下面积为0.818,APACHE-Ⅱ评分曲线下为面积0.789,TAP曲线下面积为0.675,IL-6曲线下面积为0.693,α-MSH、TAP及IL-6联合ROC曲线下面积为0.906.结论 α-MSH、TAP、IL-6对急性胰腺炎病情严重度的评估具有一定的临床价值,其中α-MSH在病情评估方面的准确性均高于TAP及IL-6,三者联合检测拥有更高准确度.