铁死亡相关指标表达与重症胰腺炎患者临床预后的关系

doi:10.3969/j.issn.1006-6233.2024.04.021

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摘要 目的: 分析铁死亡相关指标血清铁蛋白(SF)水平与重症胰腺炎(SAP)患者临床预后的关系。方法: 本研究回顾性分析了2022年1月至2022年12月期间本院收治的76例SAP患者。在住院后第1、3和7天获得血清SF水平,并根据第1天血清SF水平是否大于275ng/mL将患者人群分为两组:SF水平升高组(n=36)和SF水平正常组(n=40)。分析SF水平与CRP水平、APACHEⅡ评分、CTSI评分的相关性,及其预测SAP患者的能力。结果: 与SF水平正常组相比,SF水平升高组第1、7天APACHEⅡ评分、第7天CTSI评分、第1、3、7天SF水平和死亡率均显著增加(P<0.05)。第1天SF水平与第1、7天APACHEⅡ评分,第1、7天CTSI评分和第7天CRP水平呈显著正相关性(r=0.236、0.495、0.269、0.582、0.362,均P<0.05)。在Cox生存分析中,病因、第1天SF水平、第7天CTSI评分、持续性器官衰竭是与SAP患者死亡相关的独立影响因素(均P<0.05)。ROC分析显示,入院第1天SF水平对SAP患者的死亡具有最高预测能力(AUC=0.851),显著高于同期的APACHEⅡ评分(AUC=0.630)和CTSI评分(AUC=0.693)。结论: 早期SF水平升高与SAP不良预后有关,并可作为患者死亡的潜在预测因子。

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关键词 ：血清铁蛋白, 重症胰腺炎, 临床预后, 铁死亡

Abstract：Objective: To analyze the relationship between serum ferritin (SF) level, an indicator of ferroptosis, and the clinical prognosis of patients with severe acute pancreatitis (SAP). Methods: This study retrospectively analyzed 76 patients with SAP who were admitted to our hospital from January to December 2022. Serum SF levels were obtained on days 1, 3, and 7 after admission, and patients were divided into two groups according to whether the serum SF level on day 1 was greater than 275 ng/mL: the elevated SF level group (n=36) and the normal SF level group (n=40). The correlation between SF level and CRP level, APACHE II score, and CTSI score was analyzed, as well as its ability to predict SAP patients. Results: Compared with the normal SF level group, the elevated SF level group had significantly increased APACHE II scores on days 1 and 7, CTSI score on day 7, SF levels on days 1, 3, and 7, and mortality rate (P<0.05). The SF level on day 1 was significantly positively correlated with the APACHE II scores on days 1 and 7, CTSI scores on days 1 and 7, and CRP level on day 7 (r=0.236, 0.495, 0.269, 0.582, 0.362, respectively; all P<0.05). In Cox survival analysis, etiology, SF level on day 1, CTSI score on day 7, and persistent organ failure were independent risk factors for death in SAP patients (all P<0.05). ROC analysis showed that the SF level on day 1 of admission had the highest predictive ability for death in SAP patients (AUC=0.851), which was significantly higher than the APACHE II score (AUC=0.630) and CTSI score (AUC=0.693) at the same time. Conclusion: Early elevated SF level is associated with poor prognosis of SAP and can be used as a potential predictor of death in patients.

Key words： Serum ferritin Severe acute pancreatitis Clinical prognosis Ferroptosis

基金资助:江苏省卫生健康委员会科研项目,(编号:20220618)

通讯作者: 梅道菊

引用本文:

喻露, 兰智新, 周与华, 梅道菊. 铁死亡相关指标表达与重症胰腺炎患者临床预后的关系[J]. 河北医学, 2024, 30(4): 640-646.
YU Lu, LAN Zhixin, et al. Relationship Between Expression of Ferroptosis-Related Indicators and Clinical Prognosis of Patients with Severe Acute Pancreatitis. HeBei Med, 2024, 30(4): 640-646.

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http://www.hbyxzzs.cn/CN/10.3969/j.issn.1006-6233.2024.04.021 或 http://www.hbyxzzs.cn/CN/Y2024/V30/I4/640

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