急性胰腺炎患儿血清ACE2、ApoB/A1比值与病情程度及预后的关系
Relationship of Serum ACE2,ApoB/A1 Ratio with Severity and Prognosis of Acute Pancreatitis in Children
王改 1侯梦妍1
作者信息
- 1. 071000 河北 保定,首都医科大学附属北京儿童医院保定医院消化内科
- 折叠
摘要
目的 研究急性胰腺炎(AP)患儿血清血管紧张素转化酶2(ACE2)、载脂蛋白B/A1(ApoB/A1)比值与病情程度及预后的关系.方法 选取2021 年4 月—2023 年10 月116 例AP患儿,其中轻中症69 例、重症47 例.比较不同病情程度患儿血清ACE2、ApoB/A1 比值及病情程度相关评分[急性胰腺炎严重程度床边指数(BISAP)、Ranson评分、急性生理学与慢性健康状况评分系统Ⅱ(APACHE Ⅱ)];分析血清ACE2、ApoB/A1 比值与病情程度评分的相关性;统计116 例患儿预后,比较不同预后患儿血清ACE2、ApoB/A1 比值,采用相对危险度分析血清ACE2、ApoB/A1 比值对AP患儿预后不良风险的影响;采用受试者工作特征(ROC)曲线评价血清ACE2、ApoB/A1 比值对AP患儿预后的预测价值.结果 轻中症组血清ACE2 水平较重症组高,ApoB/A1 比值及BISAP、Ranson、APACHE Ⅱ评分均低于重症组(P<0.01).Pearson相关性分析显示,AP患儿血清ACE2 水平均与BISAP、APACHE Ⅱ、Ranson评分呈负相关,ApoB/A1 比值均与BISAP、Ranson、APACHEⅡ评分呈正相关(P<0.01).预后不良患儿血清ApoB/A1 比值高于预后良好患儿,ACE2 水平低于预后良好患儿(P<0.05).血清ACE2 低水平亚组预后不良风险是高水平亚组的 4.667(95％CI:1.416,15.380)倍;ApoB/A1 比值高水平亚组预后不良风险是低水平亚组的 3.250(95％CI:1.126,9.380)倍.ROC曲线显示,血清ACE2、ApoB/A1 比值联合预测AP患儿预后的曲线下面积为0.927,明显高于各指标单独预测.结论 血清ACE2、ApoB/A1 比值与AP患儿病情程度具有明显相关性,且两项指标联合检测对AP患儿预后有较好预测价值.
Abstract
Objective To investigate the relationship of serum angiotensin converting enzyme 2(ACE2)and Apoli-poprotein B/A1(ApoB/A1)ratio with the severity and prognosis of acute pancreatitis(AP)in children.Methods From April 2021 to October 2023,116 children with AP were selected,including 69 children with mild and moderate AP and 47 children with severe AP.The serum ACE2,ApoB/A1 ratio and the scores related to the severity of the disease[bedside index for severity in acute pancreatitis(BISAP)score,Ranson scoring,Acute Physiology and Chronic Health Status Score System Ⅱ(APACHE Ⅱ)]were compared in children with different severity levels.The correlation between serum ACE2,ApoB/A1 ratio and the score of disease severity was analyzed.The prognosis of 116 children with AP was analyzed,and the serum ACE2 and ApoB/A1 ratio of children with different prognosis were compared.The influence of serum ACE2 and ApoB/A1 ratios on the risk of adverse prognosis of AP children was analyzed by relative risk degree.Receiver operating characteristic(ROC)curve was used to evaluate the prognostic value of serum ACE2 and ApoB/A1 ratio in children with AP.Results The serum ACE2 level in mild and moderate group was higher than that in severe group,while the ApoB/A1 ratio and the scores of BISAP,Ranson and APACHE Ⅱ were lower than those in severe patients(P<0.01).Pearson correlation analysis showed that the serum ACE2 level of AP children was negatively correlated with the scores of BISAP,APACHE Ⅱ and Ran-son,and that the ApoB/A1 ratio was positively correlated with the scores of BISAP,Ranson and APACHEⅡ(P<0.01).The serum ApoB/A1 ratio in children with poor prognosis was higher than that in children with good prognosis,while the level of ACE2 was lower than that in children with good prognosis(P<0.05).The risk of adverse prognosis was 4.667(95％CI:1.416,15.380)times higher in the low level of serum ACE2 subgroup than in the high level subgroup.The risk of poor prog-nosis in the high ApoB/A1 ratio subgroup was 3.250(95％CI:1.126,9.380)times that in the low ApoB/A1 ratio sub-group.ROC curve showed that the area under the ROC curve of combining serum ACE2 and ApoB/A1 ratio to predict the prognosis of AP children was 0.927,which was significantly higher than that predicted by each indicator alone.Conclusion Serum ACE2 and ApoB/A1 ratio is significantly correlated with the disease severity of AP children,and the combined detec-tion of the two indexes has a good prognostic value for AP children.
关键词
急性胰腺炎/儿童/血管紧张素转化酶2/载脂蛋白B/A1/相关性/受试者工作特征曲线/预后/预测价值Key words
Acute pancreatitis/Children/Angiotensin converting enzyme 2/Apolipoprotein B/A1/Correlation/ROC curve/Prognosis/Predictive value引用本文复制引用
出版年
2024
国家科技期刊平台
NSTL
维普
万方数据