Objective To study the significance of S100A12 in patients with acute pancreatitis (AP).Methods 139 patients with AP were divided into the severe acute pancreatitis (SAP) and moderate acute pancreatitis (MAP) groups.61 patients in the SAP group were further subdivided into the infection group (n =32) and the non-infection group (n =29) based on the presence/absence of secondary infection.Serum samples of these patients were collected on the 3rd,7th and 14th day after treatment.ELISA was used to determinate the S100A12,IL-1 β and IL-6 levels in serum.The area under ROC was used to evaluate the predictive role of S100A12,IL-1β,IL-6 and CRP for infection in patients with SAP.Results The S100A12,IL-1β and IL-6 levels in SAP patients were markedly higher than those in MAP patients and normal controls on the 3rd,7th and 14th day after treatment.These levels decreased toward normal range in MAP patients.They were persistently high in SAP patients after treatment for 7 days,but decreased significantly after 14 days.The serum levels of S100A12,IL-1β,IL-6 and CRP were significantly higher in the infection subgroup(647.5 ± 300.1,155.9 ±48.5,95.7 ±25.5,166.8 ±53.0) than the non-infection subgroup(249.0 ± 176.3,108.0 ± 46.1,64.0 ±38.5,117.9 ±34.9) (P ＜0.05).The sensitivity and specificity of serum S100A12 in diagnosing secondary infection in SAP were 96.8％ and 83.3％,which were higher than those of serum IL-1β,IL-6 or CRP.Conclusion The level of S100A12 was associated with systemic inflammatory response syndrome (SIRS) in AP,and it may serve as a new marker in early diagnosis of SAP and in secondary infection in SAP.%目的 探讨急性胰腺炎(AP)患者血清钙结合蛋白S100A12的表达及临床意义.方法 139例AP患者分为轻症组(MAP)61例和重症组(SAP) 78例.40例健康献血者作为对照组.61例SAP患者根据是否合并胰腺坏死组织感染分为感染组(32例)和未感染组(29例).采用双抗夹心酶联免疫吸附测定法检测患者外周静脉血中S100A12、IL-6和IL-1β的含量.观察入院后第1、3、7、14天S100A12、IL-1β和IL-6水平动态变化,并分析S100A12变化的临床意义.使用受试者工作特征曲线(ROC)下面积分析S100A12、IL-1β、IL-6和C反应蛋白(CRP)在感染评估方面的价值.结果 SAP组血清S100A12、IL-1β和IL-6在第1、4、7天均显著高于MAP组.MAP组在治疗第7天下降接近正常,而SAP组在治疗第7天时仍显著高于第1天.SAP感染组S100A12评分为647.5±300.1,IL-1β评分为155.9±48.5,IL-6评分为95.7±25.5,CRP评分为166.8±53.0,显著高于非感染组评分(249.0±176.3,108.0±46.1,64.0±38.5,117.9±34.9),差异具有统计学意义(P＜0.05).S100A12评估SAP合并感染的敏感性和特异性最高,分别为0.968和0.833.结论 S100A12和全身炎症反应密切相关.SAP发生时,S100A12水平增高,可用于预测AP的严重程度及评估是否合并感染.S100A12有可能成为鉴别急性胰腺炎严重程度的一个新指标.
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