目的 探讨血清中细胞间黏附分子-1(ICAM-1)、铁蛋白(SF)水平变化对急性胰腺炎严重程度评估的临床意义。方法 收集内蒙古医科大附属医院(2014年-2018年)急性胰腺炎(Acute pancreatitis AP)患者73例作为研究对象,其中轻症急性胰腺炎组43例( MAP组,n=43),重症急性胰腺炎组30例(SAP组,n=30)。在发病第24h、48h、72h和96h分别对所有患者进行ICAM-1、SF检测,同时行AP严重程度Ranson评分和CT严重程度指数(CTSI)评分。对2组患者不同时间段ICAM-1、SF、Ranson评分和CTSI评分进行比较,同时进行ICAM-1、SF与Ranson评分和CTSI评分的相关性分析。结果 (1)发病第24h,MAP的ICAM-1、SF平均值(29.68 ± 8.04 vs16.77±4.37)、( 908.7±158.6 vs719.6±208.5)均较SAP组低,有显著性差异(P均＜0.001)。两组患者发病第24h血清中ICAM-1、SF水平明显高于其入院后24h、72-96h(P均＜0.001)。患者入院后Ranson评分和CTSI评分均与ICAM-1、SF水平密切相关(r均＞0.9)。结论 患者血清ICAM-1、SF水平及其变化对于急性胰腺炎严重程度及预后具有预估作用。

ICAM-1 and SF levels in evaluating the severity of acute pancreatitis. Methods 73 patients admitted to our hospital from 2014 to 2018 were divided into mild AP (MAP group) 43 cases and severe AP (SAP group) 30 cases. Intercellular adhesion molecule-1 (ICAM-1) and ferritin (SF) were measured at 24h, 48h, 72h and 96h after onset, and AP severity Ranson score and CT severity index (CTSI) were also evaluated. ICAM-1,SF, Ranson score and CTSI score were compared in two groups at different time points, and the correlation between ICAM-1, SF and Ranson score and CTSI score was analyzed. Result At 24 hours after onset, the mean ICAM-1 and SF of MAP were lower than those of SAP group (29.68 (+8.04 vs 16.77 (+4.37), (908.7 (+158.6 vs 719.6 (+208.5). The difference was statistically significant (P < 0.001). The serum levels of ICAM-1 and SF were significantly higher at 48h-72h than at 24h and 72-96h (P < 0.001). Ranson score and CTSI score were closely related to the levels of ICAM-1 and SF after admission (r > 0.9). Conclusion Serum ICAM-1 and SF levels and their changes can predict the severity and prognosis of acute pancreatitis.

内蒙古自治区科技攻关计划(项目批号：2019GG085：构建以外科为基础针对胰腺癌免疫微环境的精准化胰腺癌综合诊治体系研究 )