ABSTRACT
Objective To investigate the dynamic changes of soluble fms-like tyrosine kinase 1 (sFlt-1),Amylase (AMY) and high sensitvie C reactive protein (hs-CRP) in the early diagnosis of acute pancreatitis (AP) and its clinical significance.Methods 72 patients with AP were selected and divided into mild group (n =45) and severe group (n =27).Another 30 healthy subjects in the same period were selected as control group (n =30).Serum sFlt-1 levels were measured by enzyme-linked immunosorbent assay (ELISA) on the 1st,3rd and 7th day after admission.Acute Physiology and Chronic Health Evaluation Ⅱ (APACHE Ⅱ) score was used to assess acute physiology and chronic health status,and AMY and hsCRP levels were measured.Results Serum levels of sFlt-1,AMY and hs-CRP in the severe group were significandy higher than those in the mild group on the 1 st,3rd and 7th day after admission (all P ＜ 0.01).The levels of sFlt-1,AMY and hs-CRP in the mild group were significantly higher than those in the control group (all P ＜ 0.01).The scores of APACHE Ⅱ in the severe group were significantly higher than those in the mild group on the 1st,3rd and 7th day after admission (all P ＜ 0.01).There was a positive correlation between serum sFlt-1 level and AMY,hs-CRP,APACHE Ⅱ scores on the first day of admission (respectively r =0.738,P =0.00;r =0.563,P =0.000;r =0.233,P =0.028),on the third day of admission (respectively r =0.622,P =0.000;r =0.584,P =0.000;r =0.218,P =0.032),on the seventh day of admission (respectively r =0.593,P =0.000;r =0.547,P =0.000;r =0.227,P =0.030).Receiver operating characteristic (ROC) curve analysis showed that the area under the curve (AUC) of serum sFlt-1,AMY and hs-CRP were 0.918 (95％ CI:0.865-0.971,P =0.000),0.948 (95％ CI:0.908-0.989,P=0.000) and 0.789 (95％ CI:0.696-0.882,P=0.000),respectively.Conclusions The level of sFlt-1 in peripheral blood is significantly increased in patients with AP,which is closely related to the severity of AP.Dynamic monitoring of serum sFlt-1,AMY and hs-CRP has important clinical value in the diagnosis,treatment,severity and prognosis of AP.
ABSTRACT
Objective To explore the association between inflammatory cytokines and islet β-cell function in chronic persistent asthma patients. Methods 112 adults with persistent asthma and 60 healthy volunteers were enrolled in this study. According to the severity of disease, all subjects were divided into persistent-mild group and persistent-moderate group. Plasma tumor necrosis factor-α(TNF-α), interleukin6(IL-6) and C-reactive protein (CRP) were determined. Oral glucose tolerance and insulin releasing test were performed. The ratio of the area under the curve of insulin to area under the curve of glucose ( AUC1/AUCG ), homeostasis model assessment for insulin resistance ( HOMA-IR), insulin sensitivity index( ISI),homeostasis model assessment for β-cell function (HBCI) and early insulin secretion index(△I30/△G30)were calculated. The values of forced expiratory volume in l second ( FEV1 ), forced vital capacity(FVC)and FEV1/FVC were recorded. Results In patient groups, the values for plasma TNF-α, IL-6, CRP,AUC1, AUC1/AUCG, HOMA-IR, HBCI significantly increased compared with those in control group, while ISI declined ( t =2. 02～13.62, P ＜0. 05). Multiple step regression analysis showed that HOMA-IR was positively correlated with CRP, LDL-C, BMI, AUC1, TNF-α( P ＜0. 01 orP ＜0. 05), but negatively correlated with FEV1 ( P ＜ 0. 05 ). Conclusion The results indicated that inflammatory cytokines ( TNF-α,IL-6,CRP) might result in insulin resistance in asthma patients who had hyperinsulinism at the same time.