胱抑素C在急性胰腺炎并发全身炎症反应综合征致多器官功能障碍综合征患者中的变化

摘要

目的：观察胱抑素 C(cystatin-C,Cys-C)在急性胰腺炎(acute pancreatitis,AP)并发全身炎症反应综合征(systemic inflammatory response syndrome,SIRS)致多器官功能障碍综合征(multiple organ dysfunction syndrome, MODS)患者中的变化。方法 AP 患者178例,根据其并发 SIRS、MODS 情况分为3组：AP 组127例、SIRS 组30例、MODS 组21例。同时,收集健康体检者30例作为正常对照组。测定所有待测者血清 Cys-C、降钙素原(procalcitonin,PCT)、超敏 C 反应蛋白(hypersensitive C-reactive protein,hs-CRP)水平,观察 Cys-C 水平与 AP 并发SIRS、MODS 情况,以及其与血清 hs-CRP、PCT 水平的相关性。结果与对照组比较,观察组血清 Cys-C、PCT、hs-CRP 水平均明显升高(P <0.01)。与 AP 组比较,SIRS、MODS 组升高更为明显,以 MODS 组更为突出(P <0.05或P <0.01)。相关性分析表明,血清 Cys-C 水平与 PCT、hs-CRP 呈正相关。结论 Cys-C 与炎症反应关系密切,参与了 AP 并发 SIRS、MODS,并具有重要作用。%Objective To observe the change of cystatin-C (Cys-C)in acute pancreatitis (AP)leading to systemic inflammatory response syndrome (SIRS)which causes multiple organ dysfunction syndrome (MODS). Methods A total of 1 78 AP cases were divided into three groups:simple AP (AP group)127 cases,AP accompanied with SIRS (SIRS group)30 cases,AP accompanied with MODS (MODS group)21 cases.Thirty healthy subjects from body check served as normal control group.The levels of serum Cys-C,procalcitonin (PCT),hypersensitive C-reactive protein (hs-CRP)were detected in all participants.Analysis was made in the correlation between the serum Cys-C levels and the incidence of AP accompanied with SIRS,MODS.The correlation was explored in serum Cys-C level and PCT,hs-CRP level.Results The serum Cys-C,hs-CRP and PCT levels in patients with AP,SIRS and MODS increased significantly compared with those in normal control group (P <0.01).The serum Cys-C,PCT and hs-CRP levels in patients with MODS were significantly higher than those in patients with AP,SIRS (P <0.05 or P <0.01).The serum Cys-C level positively correlated with serum PCT and hs-CRP levels.Conclusion Cys-C closely related to inflammation,and it might play significant role in AP leading to SIRS which causes MODS.