Abstract:Objective: To explore the levels of serum P-selectin and vWF in elderly patients with acute pancreatitis (AP) and their relationship with prognosis. Methods: A total of 159 AP patients who were treated in the hospital from June 2016 to June 2019 were enrolled as study group, while another 58 healthy controls during the same period were enrolled as control group. The levels of serum P-selectin and vWF were measured and compared between the two groups. The differences in P-selectin and vWF levels were compared among AP patients with different severity and prognosis. The single factors and independent risk factors that affected prognosis of AP patients were explored. The value of P-selectin, vWF and their combination in predicting prognosis of AP was explored. Results: Compared with control group, levels of serum P-selectin and vWF were significantly increased in study group (P<0.05). With the exacerbation of AP, levels of serum P-selectin and vWF were significantly increased (P<0.05). Compared with survival group, levels of serum P-selectin and vWF were significantly increased in death group (P<0.05). ROC curve analysis showed that AUC of P-selectin combined with vWF for predicting prognosis was significantly higher than that of P-selectin and vWF alone (0.935 vs 0.841, 0.833) (P<0.05). The results of univariate analysis on 28d survival rate of AP patients showed that there were certain effects of drinking history, cholelithiasis, scores of RANSON and BISAP, AP severity, P-selectin and vWF on 28d survival rate of AP patients (P<0.05). The results of Logistic multivariate analysis showed that drinking, cholelithiasis, RASON score not lower than 3 points, BISAP score not lower than 3 points, SAP, P-selection VWF not lower than 64.31μg/mL and vWF not lower than 231.68% were all independent risk factors affecting the 28d survival rate of AP patients (P<0.05). Conclusion: The levels of serum P-selectin and vWF in elderly AP patients are significantly increased, which are closely related to their prognosis. The combination of the two is of good clinical application value in predicting prognosis of AP patients.
黄祥妹, 李俊, 王雪娇, 孙少清, 陈秀红, 邓小彦. 老年急性胰腺炎患者血清P-选择素 vWF水平及其与预后的关系[J]. 河北医学, 2021, 27(5): 751-756.
HUANG Xiangmei, LI Jun, WANG Xuejiao, et al. Levels of Serum P-Selectin and VWF in Elderly Patients with Acute Pancreatitis and Their Relationship with Prognosis. HeBei Med, 2021, 27(5): 751-756.
[1] 张宇艳,张海蓉,张景丽,等.连续性血液净化治疗重症急性胰腺炎的研究进展[J].临床肝胆病杂志,2020,36(6):1428~1432. [2] Paulina D,Dawid M,Piotr C,et al.The Interplay between Inflammation,coagulation and endothelial injury in the early phase of acute pancreatitis: clinical implications [J].International Journal of Molecular Ences,2017,18(2): 354. [3] Mager D J,Bruno M J,Hallensleben N D L,et al.Pancreatic exocrine insufficiency following acute pancreatitis: systematic review and study level meta-analysis [J].Pancreatology: official journal of the International Association of Pancreatology (IAP),2018,18(3): 253~262. [4] 王兴鹏,李兆申,袁耀宗,等.中国急性胰腺炎诊治指南(2013年,上海)[J].胃肠病学,2013,29(7):656~660. [5] 韩亮,王前波,肖详.BISAP评分联合促炎/抗炎细胞因子检测对重症急性胰腺炎预后的评估价值[J].贵州医药,2020,44(8):1304~1305. [6] 郭晓钟.急性胰腺炎营养支持治疗的研究进展[J].中华消化杂志,2020,40(7):437~440. [7] Xuan,Chen,Meifang,et al.Effectiveness of continuous veno-venous hemofiltration in the treatment of severe acute pancreatitis [J].Experimental & Therapeutic Medicine,2019,17(4): 2720~2724. [8] Yang Y,Liu X,Liu Y,et al.The development of salt-sensitive hypertension regulated by PSGL-1 gene in mice [J].Cell and Bioence,2018,8(1): 20. [9] 程静,徐路,彭素琼.肝血流超声参数联合外周血vWF-Ag对肝硬化患者食管静脉曲张出血的预测价值[J].肝脏,2020,25(3):260~263. [10] 何冬梅,杨铁柱,刘燕,等.P-选择素糖蛋白配体-1在急性重症胰腺炎发生中的作用[J].中华实验外科杂志,2020,37(3):477~479. [11] 张玲,黄莺,杨婷婷.sICAM-1、P-选择素及D-二聚体在急性胰腺炎患者中的变化及相关性[J].医学临床研究,2019,36(8):1478~1479,1482. [12] 朱清,黄重发,卜全慧,等.血必净对重症急性胰腺炎患者炎症因子、血管内皮功能及单核细胞HLA-DR表达的影响[J].遵义医学院学报,2018,41(4):457~460. [13] 余明军,王海明.老年急性胰腺炎临床特点及其预后相关因素的回顾性研究[J].浙江中西医结合杂志,2020,30(6):514~516.