| 钟 建,罗 林,张 卫,刘 强,潘 磊,唐志强.血清TWEAK、SIRT1水平与高脂血症性急性胰腺炎患者病情严重程度及预后的关系研究[J].,2024,(18):3590-3594 |
| 血清TWEAK、SIRT1水平与高脂血症性急性胰腺炎患者病情严重程度及预后的关系研究 |
| Study on the Relationship between Serum TWEAK and SIRT1 Levels and the Severity of Condition and Prognosis of Patients with Hyperlipidemic Acute Pancreatitis |
| 投稿时间：2024-02-27 修订日期：2024-03-23 |
| DOI：10.13241/j.cnki.pmb.2024.18.036 |
| 中文关键词: 高脂血症性急性胰腺炎 TWEAK SIRT1 病情严重程度 预后 |
| 英文关键词: Hyperlipidemic acute pancreatitis TWEAK SIRT1 Severity of condition Prognosis |
| 基金项目:2020年四川省卫生健康适宜技术推广立项项目（20PJ0313） |
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| 中文摘要: |
| 摘要 目的：探讨血清肿瘤坏死因子样凋亡微弱诱导剂（TWEAK）、沉默信息调节蛋白1（SIRT1）与高脂血症性急性胰腺炎（HLAP）患者病情严重程度及预后的关系，以期为评估HLAP患者病情并改善预后提供参考依据。方法：选取2021年11月～2023年5月资阳市第一人民医院重症监护室（ICU）收治的167例HLAP患者作为HLAP组，同期体检健康志愿者88名作为对照组。根据病情严重程度将HLAP患者分为轻症HLAP组（n=66）、中度重症HLAP组（n=58）、重症HLAP组（n=43）。根据院内结局将HLAP患者分为死亡组（n=36）、存活组（n=131）。采用酶联免疫吸附法检测血清TWEAK、SIRT1水平。采用多因素Logistic回归分析影响HLAP患者预后的因素，采用受试者工作特征（ROC）曲线分析血清TWEAK、SIRT1水平预测HLAP患者死亡的价值。结果：与对照组比较，HLAP组血清TWEAK水平升高，SIRT1水平降低（P＜0.05）。轻症HLAP组、中度重症HLAP组、重症HLAP组血清TWEAK水平依次升高，SIRT1水平依次降低（P＜0.05）。重症HLAP、ICU停留时间延长和CRP、TWEAK升高为影响HLAP患者预后的独立危险因素，SIRT1升高为独立保护因素（P＜0.05）。血清TWEAK、SIRT1水平联合（AUC＝0.900，95%CI：0.844～0.941）预测HLAP患者死亡的曲线下面积（AUC）大于血清TWEAK（AUC＝0.786，95%CI：0.716～0.846）、SIRT1（AUC=0.794，95%CI：0.724～0.852）水平单独预测（P＜0.05）。结论：HLAP患者血清TWEAK水平升高，SIRT1水平降低，与病情严重加重和预后密切相关。血清TWEAK、SIRT1水平联合预测HLAP患者预后的价值较高。 |
| 英文摘要: |
| ABSTRACT Objective: To investigate the relationship between serum tumor necrosis factor-like weak inducer of apoptosis (TWEAK) and sirtuin1 (SIRT1) and the severity of condition and prognosis of patients with hyperlipidemic acute pancreatitis (HLAP), in order to provide reference basis for evaluating the condition and improving prognosis of HLAP patients. Methods: 167 HLAP patients admitted to the intensive care unit (ICU) of Ziyang First People's Hospital from November 2021 to May 2023 were selected as HLAP group, and 88 healthy volunteers during the same period were selected as control group. HLAP patients were divided into mild HLAP group (n=66), moderate severe HLAP group (n=58) and severe HLAP group (n=43) according to the severity of the disease. According to the in-hospital outcome, HLAP patients were divided into death group (n=36) and survival group (n=131). Serum TWEAK and SIRT1 levels were detected by enzyme-linked immunosorbent assay. Factors affecting the prognosis of HLAP patients was analyzed by multivariate logistic regression analysis, and the value of serum TWEAK and SIRT1 levels in predicting the death of HLAP patients was analyzed by the receiver operating characteristic (ROC) curve. Results: Compared with control group, the serum TWEAK level was increased and the SIRT1 level was decreased in HLAP group(P＜0.05). The levels of serum TWEAK in mild HLAP group, moderate severe HLAP group and severe HLAP group increased in turn, and the levels of SIRT1 decreased in turn(P＜0.05). Independent risk factors affecting the prognosis of patients with HLAP were severe HLAP, prolonged ICU stay and CRP, TWEAK were elevated, and the independent protective factor was the elevation of SIRT1(P＜0.05). The area under the curve (AUC) of serum TWEAK and SIRT1 levels combined (AUC=0.900, 95% CI: 0.844 to 0.941) predicted death in patients with HLAP was greater than that predicted by serum TWEAK (AUC=0.786, 95% CI: 0.716 to 0.846) and SIRT1 (AUC=0.794, 95% CI: 0.724 to 0.852) levels alone predicted (P＜0.05). Conclusion: The level of serum TWEAK in HLAP patients is increase, and the level of SIRT1 is decrease, which is closely relate to the severity and prognosis of the disease. The combination of serum TWEAK and SIRT1 levels has a high value in predicting the prognosis of HLAP patients. |
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