血清 PCT、NETs、MFG-E8、TLR 9 与重症急性胰腺炎患者肠黏膜屏障 功能的相关性分析及对预后的影响.

ABSTRACT Objective: To analyze the correlation between serum procalcitonin (PCT), neutrophil extracellular trapping nets (NETS), milk fat globule-epidermal growth factor 8 (MFG-E8), toll like receptor 9 (TLR 9) and intestinal mucosal barrier function in patients with severe acute pancreatitis (SAP), and to observe their effects on the prognosis. Methods: The clinical data of 174 patients with SAP (SAP group) who were treated in our hospital from March 2019 to January 2022 were retrospectively analyzed. In addition, the clinical data of 90 volunteers (control group) who came to our hospital for physical examination in the same period were collected and analyzed. The levels of serum PCT, NETs, MFG-E8, TLR 9, endotoxin (LPS), D-lactic acid and diamine oxidase (DAO) in the control group and SAP group were compared, and the correlation between PCT, NETS, MFG-E8, TLR 9 and intestinal mucosal barrier function indexes was analyzed. Among the 174 patients, 39 patients died within 28 days after admission and 135 patients survived. According to prognosis within 28 d, they were divided into death group (n=39) and survival group (n=135). Univariate and multivariate Logistic regression analysis were used to analyze the influencing factors of prognosis. Results: The levels of serum PCT, NETS and TLR 9 in SAP group were higher than those in the control group, and the MFG-E8 level was lower than that in the control group (P<0.05). The levels of serum LPS, D-lactic acid and DAO in the SAP group were higher than those in the control group (P<0.05). Pearson correlation analysis confirmed that LPS, D-lactic acid and DAO were positively correlated with PCT, NETS and TLR 9, and negatively correlated with MFG-E8 (P<0.05). Univariate analysis showed that: the prognosis of patients with SAP was related to age, diabetes mellitus, blood amylase, acute physiological function and chronic health score System Ⅱ (APACHE Ⅱ) score, acute pancreatitis severity bedside index (BISAP) score, LPS, D-lactic acid, DAO, PCT, NETs, MFG-E8, TLR 9, reducing alcohol consumption, low fat diet (P<0.05). Multivariate Logistic regression analysis showed that: high BISAP score, high APACHE Ⅱ score, high LPS, high PCT, high blood amylase, high D-lactic acid, high DAO, high NETs, low MFG-E8 and high TLR 9 were risk factors for the prognosis of patients with SAP. Reducing alcohol consumption and low fat diet were the protective factors for the prognosis of patients with SAP (P<0.05). Conclusion: The levels of serum PCT, NETs, MFG-E8 and TLR 9 in patients with SAP are abnormal and correlated with intestinal mucosal barrier function. Meanwhile, blood amylase, APACHEⅡ score, BISAP score, LPS, PCT, D-lactic acid, DAO, NETs, MFG-E8 and TLR 9 are risk factors for the prognosis of patients with SAP, while reducing alcohol consumption and low fat diet are protective factors for the prognosis of patients with SAP. Early clinical evaluation should be paid attention to to improve the prognosis of patients. [ABSTRACT FROM AUTHOR]