急性胆囊炎患者血浆β-防御素-3的检测及临床意义

摘要

Objective To study the changes of plasma beta-defensin-3 level were determined in patients with acute cholecystitis and its correlation with disease was evaluated.Methods 82 consecutive patients with acute cholecystitis including 15 patients with a-cute gangrenous cholecystitis and 50 healthy controls were enrolled into this study.Plasma beta-defensin-3 concentration was measured by ELISA.Its correlation with disease was analyzed statistically.Results The plasma beta-defensin-3 level ( 81.4 ± 36.9 pg/ml) in patients with acute cholecystitis was significantly lower than that ( 154.2 ± 28.3 pg/ml) in healthy controls( t = 8.957, P < 0.001) and the plasma beta-defensin-3 level (64.2 ±24.1 pg/ml) in patients with acute gangrenous cholecystitis was significantly lower than that (94.3 ±29.9 pg/ml) in patients without acute gangrenous cholecystitis( t =9.478, P <0.001) using t test.On a multivariate logistic regression, plasma beta-defensin-3 level was an independent variable predicting acute cholecystitis (OR =0.483, 95% CI = 0.298 ~ 0.709, P < 0.01) and acute gangrenous cholecystitis (OR = 0.426, 95% CI = 0.239 ~ 0.648, P < 0.01).A receiver operating characteristic curve identified that a plasma beta-defensin-3 level significantly predicted acute cholecystitis (Area under curve =0.824, 95% CI = 0.712 ~0.896, P <0.001) and acute gangrenous cholecystitis (Area under curve = 0.836, 95% CI = 0.723 ~ 0.904, P < 0.001) .Conclusion Decreased beta-defensin-3 is found after acute cholecystitis and low beta-defensin-3 may be independently associated with acute cholecystitis.%目的:揭示急性胆囊炎患者血浆β-防御素-3浓度的变化,探讨其与急性胆囊炎患病危险性的相关性.方法:收集急性胆囊炎患者作为胆囊炎组,共82例,其中坏疽性胆囊炎15例,非坏疽性胆囊炎67例.收集同期健康体检者作为对照组,共50例.ELISA检测血浆β-防御素-3浓度.统计分析其与急性胆囊炎患病危险性的相关性.结果:t检验显示,胆囊炎组患者血浆β-防御素-3浓度(81.4±36.9)pg/ml显著低于对照组血浆β-防御素-3浓度(154.2±28.3)pg/ml(P<0.001),坏疽性胆囊炎患者血浆β-防御素-3浓度(64.2±24.1)pg/ml显著低于非坏疽性胆囊炎患者血浆β-防御素-3浓度(94.3±29.9)pg/ml(P<0.001).Logistic回归分析显示,血浆β-防御素-3浓度是罹患急性胆囊炎(OR=0.483,95%CI=0.298~0.709,P<0.01)和坏疽性胆囊炎(OR=0.426,95%CI=0.239~0.648 P<0.01)的独立危险因素.ROC曲线分析显示,血浆β-防御素-3浓度预测罹患急性胆囊炎(曲线下面积=0.824,95%CI=0.712~0.896,P<0.001)和坏疽性胆囊炎(曲线下面积=0.836,95%CI=0.723~0.904,P<0.001)有显著预测价值.结论:急性胆囊炎患者血浆β-防御素-3水平降低,可能是急性胆囊炎的危险因素.