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
ObjectiveThe study was performed to observe the change of serum levels of high mobility group protein box 1 (HMGB1) in patients with acute pancreatitis (A.P) and to determine its relationship to the severity of AP in order to reveal its clinical significance.MethodsThe serum levels of HMGB1were measured in 50 patients with AP including 24 cases of severe acute pancreatitis (SAP) and 26 cases of mild acute pancreatitis (MAP) in fnst three days after admission.The serum levels of HMGB1 were also detected in 20 healthy volunteers.Furthermore,clinical data of patients was collected and APACHE Ⅱscores were calculated at the time when serum HMGB1 levels were detected to assess the severity of the disease.The 28 day mortality of AP patients was also observed.Then,the relationship between serum HMGB1levels and the severity of AP was analyzed.ConclusionsSerum levels of HMGB1 in patients with AP were significantly positively correlated with APACHE Ⅱ scores.Serum levels of HMGB1 in patients with AP were significantly positively correlated with the 28 day mortality.HMGB1 could be used as an effective indicator to evaluate severity of AP.