Dig Dis Sci:Angiopoietin-2是急性胰腺炎患者急性胃肠道损伤和肠屏障功能障碍的早期预测因子

2021-01-13 MedSci原创 MedSci原创

在所有急性胰腺炎(AP)患者中,约有五分之一患者会进展为重症急性胰腺炎(SAP)。SAP是一种以器官衰竭和胰腺坏死为特征的严重疾病,有高达20-30%的死亡率。

      在所有急性胰腺炎(AP)患者中,约有五分之一患者会进展为重症急性胰腺炎(SAP)。SAP是一种以器官衰竭和胰腺坏死为特征的严重疾病,有高达20-30%的死亡率。迄今为止,将AP患者进行危险程度分级的最常用评分系统包括Ranson评分和急性生理与慢性健康评估II评分(APACHE II)。此外,C反应蛋白(CRP)仍然是用于预测AP不良后果的最有用的单一生化标记物。在SAP的治疗中,早期诊断AP和快速确定病情的严重性对于确保有效治疗和改善预后至关重要。急性胃肠道损伤(AGI)和肠屏障功能障碍经常导致AP并发症的出现。血管生成素2(Angiopoietin-2)已被鉴定为预测AP严重程度及其伴随并发症的有效生物标记。Ang-2是一种糖蛋白,可选择性地作用于内皮细胞,导致内皮通透性增加,因此,Ang-2可能是内皮细胞活化和全身炎症的有用的早期生物标志物。本项研究旨在评估Ang-2在诊断AP和随后的急性胃肠道损伤(AGI)进展中的预测价值。

 

 

      本项研究的研究方法很简单,研究人员前瞻性招募了170名患有AP患者和100名健康对照进行分析。所有患者都是在AP发作后24小时内收集血液样本,并进行分析。

 

 

      170名患者中有62名被分类为患有SAP。根据AGI分级指数,所有患者中共有118例1级和12例4级患者。2级和3级胃肠道损伤的患者均有20名。AP伴多器官功能衰竭(MODS)和胰腺坏死分别为46例和24例。80例患者被送入ICU,其中死亡率为7.1%。AP患者的血浆Ang-2水平高于对照组。与中重度AP患者相比,SAP患者普遍Ang-2较高。Ang-2从AGI 1级到4级显着提高。此外,通过d-乳酸(DLA),二胺氧化酶(DAO)评估,Ang-2还与肠道通透性具有强相关性。而传统的工具(Ranson和APACHE II分数,CRP)无法有效地区分AGI的各个等级。

 

 

      通过本项研究发现:Ang-2是SAP,AGI和肠屏障功能障碍的早期预测指标,优于传统的生物标志物。

 

 

 

原始出处:

Qing Huang. Et al. Angiopoietin-2 Is an Early Predictor for Acute Gastrointestinal Injury and Intestinal Barrier Dysfunction in Patients with Acute Pancreatitis. Digestive Diseases and Sciences.2021.

 

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    2021-03-11 zhaojie88
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    2021-01-15 墨墨学医

    学习

    0

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