急性胰腺炎继发器官功能衰竭患者凝血功能及外周血TIM-3 TAT ACE2水平变化分析

doi:10.3969/j.issn.1006-6233.2024.03.015

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摘要 目的:本研究旨在探究急性胰腺炎继发器官功能衰竭患者凝血功能的变化,并分析外周血中T细胞免疫球蛋白黏蛋白分子3(TIM-3)、凝血酶-抗凝血酶复合物(TAT)以及血管紧张素转换酶2(ACE2)水平的变化。方法:本研究开展时间为2020年8月至2022年8月,研究对象为在我院接受诊疗的118例急性胰腺炎患者,根据亚特兰大分级标准对患者的病情严重程度进行评价,并据此进行分组:轻度组(n=72)和重度组(n=46),对两组患者间的凝血功能指标及外周血TIM-3、TAT、ACE2水平进行比较,并探究患者继发器官功能衰竭与各指标的联系。结果:重度组患者的凝血功能指标(PT、INR、APTT和FIB)和外周血中TIM-3和TAT水平均高于轻度组,ACE2水平低于轻度组(P<0.05);继发组患者的凝血功能指标(PT、INR、APTT和FIB)和外周血中TIM-3和TAT水平均高于未继发组,ACE2水平低于未继发组(P<0.05);经多因素分析可知,PT、INR、APTT、FIB、TIM-3、TAT、ACE2均会影响患者继发器官功能衰竭,其预测患者继发器官功能衰竭的AUC值分别为0.846、0.926、0.819、0.862、0.751、0.847、0.858。结论:在急性胰腺炎患者中,凝血功能异常以及外周血中TIM-3、TAT的升高和ACE2的降低与疾病的严重程度密切相关,对急性胰腺炎继发器官功能衰竭风险有潜在的预测价值。

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	李军
	魏国峰
	蔡兆辉
	李海山

关键词 ：急性胰腺炎, 器官功能衰竭, 凝血功能, T细胞免疫球蛋白黏蛋白分子3, 凝血酶-抗凝血酶复合物, 血管紧张素转换酶2

Abstract：Objective: This study aimed to investigate alterations in coagulation function among patients with acute pancreatitis (AP) and secondary organ failure (OF) and analyze variations in peripheral blood levels of T cell immunoglobulin and mucin domain 3 (TIM-3), thrombin-antithrombin complex (TAT), and angiotensin-converting enzyme 2 (ACE2). Methods: Conducted between August 2020 and August 2022, the study involved 118 patients with AP admitted for treatment. Patient severity was assessed using the Atlanta Classification and categorized into mild (n=72) and severe (n=46) groups. Coagulation function indices and peripheral blood TIM-3, TAT, ACE2 levels were compared between the groups, investigating the relationship between secondary organ failure and these parameters. Results: Patients in the severe group exhibited significantly elevated coagulation function indices (PT, INR, APTT, and FIB) and higher peripheral blood TIM-3 and TAT levels compared to the mild group, while ACE2 levels were lower (P<0.05). Similarly, the secondary OF group showed markedly higher coagulation function indices and peripheral blood TIM-3 and TAT levels than the non-OF group, with lower ACE2 levels (P<0.05). Multifactorial analysis indicated that PT, INR, APTT, FIB, TIM-3, TAT, and ACE2 influenced the onset of secondary organ failure. The area under the ROC curve for secondary organ failure was 0.846, 0.926, 0.819, 0.862, 0.751, 0.847, and 0.858 for PT, INR, APTT, FIB, TIM-3, TAT, and ACE2, respectively. Conclusion: In patients with acute pancreatitis, abnormal coagulation and elevation of TIM-3, TAT and decreased ACE 2 in peripheral blood are strongly associated with disease severity, with potential predictive value for the risk of organ failure secondary to acute pancreatitis.

Key words： Acute pancreatitis Organ failure Coagulation function T cell immunoglobulin mucin domain 3 Thrombin-antithrombin complex Angiotensin-converting enzyme 2

基金资助:2019年安徽省重点研究与开发计划项目,(编号:201904a07020072)

引用本文:

李军, 魏国峰, 蔡兆辉, 李海山. 急性胰腺炎继发器官功能衰竭患者凝血功能及外周血TIM-3 TAT ACE2水平变化分析[J]. 河北医学, 2024, 30(3): 436-440.
LI Jun, WEI Guofeng, CAI Zhaohui, et al. Analysis of Coagulation Function and Peripheral Blood TIM-3 TAT ACE2 Levels in Patients with Acute Pancreatitis and Secondary Organ Failure. HeBei Med, 2024, 30(3): 436-440.

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http://www.hbyxzzs.cn/CN/10.3969/j.issn.1006-6233.2024.03.015 或 http://www.hbyxzzs.cn/CN/Y2024/V30/I3/436

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