血清AChE活性在急性胰腺炎病情及预后评估中的意义

摘要

目的 探讨血清乙酰胆碱酯酶(acetylcholinesterase,AChE)活性对急性胰腺炎(acute pancreatitis,AP)病情及预后评估的临床意义.方法 收集2015年4月-2016年10月在川北医学院附属医院住院治疗的AP患者及同期健康体检者的临床资料,并采集研究对象入院时空腹血清以检测AChE活性.分析影响AChE活性的临床因素,采用受试者工作特征曲线分析AChE活性与疾病严重程度及预后关系.结果 与健康对照者比较,AP患者血清AChE活性显著下降,与白蛋白含量呈明显负相关.当其值＜8.05 IU/L时,其鉴别重症AP的敏感度和特异度分别是70.6％和90.0％,曲线下面积为0.786;当其值＜6.8 IU/L时,预测死亡的敏感度和特异度分别是100％和93.0％,曲线下面积为0.978.结论 血清AChE活性可作为评估AP病情严重程度及预测死亡的生物标志物.%Objective To investigate the significance of serum acetylcholinesterase (AChE) activity in patients with acute pancreatitis (AP) and its relationship with disease severity and prognosis.Methods The clinic data of AP patients and healthy controls were collected from Apr.2015 to Oct.2016 in the Affiliated Hospital of North Sichuan Medical College.Fast serum was obtained in the morning after the admission day.Serum AChE activity was detected and its relationship with other clinical characteristics was analyzed.The correlation of AChE activity with disese severity and prognosis was analyzed by receiver operating characteristic (ROC).Results Serum AChE activity of AP patients had declined compared with healthy controls.It was inversely correlated with serum albumin.Based on ROC curves,the optimal cut-off point was 8.05 IU/L for severe AP,and the sensitivity and specificity values were 70.6％ and 90.0％,respectively.The optimal cut-off point was 6.8 IU/L for death,and the sensitivity and specificity values were 100％ and 93.0％,respectively.Conclusion Serum AChE activity can be regarded as a remarkable biomarker for disease severity and prognosis in AP patients.