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Primary biliary cholangitis （PBC） is an autoimmune liver disease characterized by progressive and non-purulent inflammation of small- and medium-sized bile ducts in the liver. Recent studies have shown that abnormal lipid metabolism is relatively common in patients with PBC， and 76% of PBC patients have dyslipidemia. The effects and harms of dyslipidemia have attracted much attention. Lipid metabolism disorders play an important role in the progression of PBC. This article mainly reviews the research advances in the manifestation， role， diagnosis， and treatment of lipid metabolism disorders in PBC， so as to provide new ideas for the treatment of PBC.
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Objective To investigate the value of urinary α1-microglobulin (α1-MG) and N-acetyl-β-D-glucosaminidase/urinary creatinine (NAG/UCr) in monitoring renal injury in patients with chronic hepatitis B virus (HBV)-related liver diseases. Methods A total of 85 patients with HBV-related liver diseases who attended The Second Affiliated Hospital of Kunming Medical University from August 2019 to August 2020 were enrolled, and according to the history of treatment with nucleos(t)ide analogues (NUC), they were divided into NUC treatment group with 57 patients and non-NUC treatment group with 28 patients; according to the type of NUC used, the NUC treatment group was further divided into entecavir (ETV) treatment group with 32 patients and tenofovir disoproxil fumarate (TDF) treatment group with 25 patients; according to the results of HBV serum antigen and antibody markers, the patients were divided into HBeAg-negative group with 57 patients and HBeAg-positive group with 28 patients; according to the results of serum HBV DNA quantification, the patients were divided into HBV DNA-negative group with 47 patients and HBV DNA-positive group with 38 patients; according to abdominal imaging findings, the patients were divided into non-liver cirrhosis group with 47 patients and liver cirrhosis group with 38 patients. The data on medical history and laboratory markers were collected for comparison between two groups. The t -test was used for comparison of normally distributed continuous data between two groups, and the Mann-Whitney U test was used for comparison of data with skewed distribution between two groups; the chi-square test was used for comparison of categorical data between two groups. The McNemar test was used to compare the diagnostic merit of each index; a Spearman correlation analysis was used to investigate the correlation of each factor with α1-MG, and NAG/UCr; the multiple linear regression analysis was used to analyze the independent influencing factors for α1-MG and NAG/UCr. Results The non-NUC treatment group, the HBeAg-positive group, and the HBV DNA-positive group had significantly higher levels of urinary α1-MG than the NUC treatment group ( Z =-2.054, P =0.04), the HBeAg-negative group ( Z =-2.293, P =0.022), and the HBV DNA-negative group ( Z =-2.229, P =0.026), respectively. The HBV DNA-positive group and the liver cirrhosis group had significantly higher levels of NAG and NAG/UCr than the HBV DNA-negative group ( Z =-2.908 and -2.824, both P < 0.05) and the non-liver cirrhosis group ( Z =-3.204 and -3.412, both P < 0.05), respectively. There was a significant difference in the proportion of patients with abnormal α1-MG and that of patients with abnormal estimated glomerular filtration rate (eGFR) (31.8% vs 20.0%, χ 2 =7.178, P =0.007), and the proportion of patients with abnormal α1-MG and NAG/UCr was significantly higher than that of patients with abnormal eGFR (35.3% vs 20.0%, χ 2 =8.049, P =0.005). There was a significant difference in diagnostic merit between α1-MG+NAG/UCr and eGFR ( P =0.015). Age ( β =0.246, P < 0.05), positive HBeAg ( β =0.284, P < 0.01), and liver cancer ( β =0.291, P < 0.01) were independent risk factors for the increase in α1-MG, while the increase in FIB-4 value ( β =0.352, P < 0.05), ascites ( β =0.260, P < 0.05), esophagogastric varices( β =-0.248, P < 0.05), positive HBV DNA ( β =0.197, P < 0.05), and high total bilirubin ( β =0.257, P < 0.05) were independent risk factors for the increase in NAG/UCr. Conclusion In patients with chronic HBV-related liver diseases, renal injury may occur during the whole course of active viral replication, liver cirrhosis, and deterioration of liver function. Antiviral therapy with NUC can alleviate renal impairment caused by HBV and is safe and reliable within a certain course of treatment. Combined measurement of urinary α1-MG and NAG/UCr has more advantages over eGFR in the diagnosis of early renal injury, and it is an effective method for renal function monitoring in patients with chronic HBV-related liver diseases.
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The liver is an important metabolic organ in the body. Studies have shown that chronic liver disease is closely associated with glucose and lipid metabolism disorders, and different types of liver diseases often show different characteristics of glucose and lipid metabolism. This article reviews the epidemiological characteristics, disease severity, pathogenesis, and treatment methods of glucose and lipid metabolism disorders in different types of chronic liver diseases, so as to improve the awareness among clinicians.
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Primary biliary cholangitis (PBC) is an autoimmune liver disease characterized by cholestasis. In recent years, a number of studies in China and globally have shown that exosomes play an important role in the development and progression of PBC, which is currently a hotspot in the field of medical research. This article reviews the role of exosomes in the pathogenesis of PBC and related research advances in the diagnosis and treatment of PBC. It is believed that exosomes have wide application prospect in PBC, and in-depth research on exosomes may bring new opportunities for the diagnosis and treatment of PBC.
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Objective To investigate the value of the CT values of thoracolumbar vertebrae measured by abdominal CT in the diagnosis of osteopenia/osteoporosis in patients with chronic hepatitis B, as well as the risk factors for osteopenia/osteoporosis in such patients. Methods A retrospective analysis was performed for 112 patients with chronic hepatitis B in the Second Affiliated Hospital of Kunming Medical University from January 2019 to December 2020. All patients underwent abdominal CT, and some patients underwent dual-energy X-ray absorptiometry (DXA). The CT values of T12 vertebral body to L3 vertebral body were measured, and the value of CT value of each vertebral body in the diagnosis of osteopenia/osteoporosis was analyzed in comparison with T-score of L1-L4 vertebral bodies measured by DXA. With the CT values of vertebral bodies as the diagnostic criteria, the patients with chronic hepatitis B enrolled were divided into osteopenia/osteoporosis group with 55 patients and normal bone mass group with 57 patients. Clinical features and biochemical parameters were compared between the two groups to analyze the risk factors for osteopenia/osteoporosis in patients with chronic hepatitis B. The t -test was used for comparison of normally distributed continuous data between groups, and the Mann-Whitney U test was used for comparison of non-normally distributed continuous data between groups; the chi-square test, the Fisher's exact test, and the Bonferroni correction test were used for comparison of categorical data between groups. A Pearson correlation analysis was performed to investigate correlation, and a binary logistic regression analysis was used for multivariate analysis. The receiver operating characteristic (ROC) curve was used to investigate the value of CT values of T12-L3 vertebral bodies in the diagnosis of osteopenia/osteoporosis in patients with chronic hepatitis B. The Kappa test was used check consistency. Results A total of 46 patients who completed abdominal CT and DXA during the same time of hospitalization were analyzed, and their CT values of T12-L3 vertebral bodies were significantly positively correlated with the T-score values of L1-L4 vertebral bodies in DXA ( r T12 =0.694, r L1 =0.661, r L2 =0.781, r L3 =0.685, all P < 0.001). The ROC curve analysis showed that the CT value of L2 vertebral body had the largest area under the ROC curve of 0.863 and showed a good accuracy in the diagnosis of osteopenia/osteoporosis, which was consistent with the results of DXA ( K =0.648, P < 0.001). The clinical features and biochemical parameters of 112 patients with chronic hepatitis B were analyzed, and it was suggested that old age (odds ratio [ OR ]=1.108, 95% confidence interval [ CI ]: 1.026-1.196, P =0.009) and sarcopenia ( OR =2.788, 95% CI : 1.009-7.707, P =0.048) were the risk factors for osteopenia/osteoporosis. Conclusion The patients with chronic hepatitis B often need regular abdominal CT to evaluate the progression of liver disease, and it is of high clinical significance to identify the presence or absence of osteopenia/osteoporosis and sarcopenia by measuring the CT value of L2 vertebral body and skeletal muscle area of L3 vertebrae plane, thereby giving timely intervention and improving patients' prognosis and quality of life.
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The incidence rate of primary biliary cholangitis (PBC) is increasing year by year, but there is still no specific medicine at present and PBC has a complex pathogenesis. Kupffer cells, as the key cells involved in immunoregulation, play an important role in PBC. When hepatocytes are damaged, Kupffer cells will be activated and release a large amount of inflammatory cytokines and chemokines, which participate in the development and progression of PBC. This article briefly reviews the role of Kupffer cells in PBC, so as to provide a theoretical basis for Kupffer cells as a potential target for the treatment of PBC.
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Primary biliary cholangitis(PBC) is a chronic autoimmune liver disease characterized by cholestasis and has unknown etiology. Its specific pathogenesis remains unclear, but hepatic macrophages are one of the key aspects of the immune and inflammatory response of PBC and the injury of biliary epithelial cells. Hepatic macrophages are classified into resident Kupffer cells and monocyte-derived macrophages according to their source, and these cells play an important role in the development and progression of PBC. This article reviews the role of hepatic macrophages in the development and progression of PBC.
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Primary biliary cholangitis (PBC) is a chronic autoimmune liver disease characterized by progressive destruction of the small intrahepatic bile ducts. Patients with PBC often have extrahepatic autoimmune diseases, which can involve multiple organs and systems including the gastrointestinal tract, lung, rheumatoid immune system, and endocrine system. This article summarizes the research advances in the disease spectrum, pathogenesis, treatment, and prognosis of PBC with extrahepatic autoimmune disease.
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Primary biliary cholangitis (PBC) is an chronic progressive intrahepatic cholestasis autoimmune liver disease with unknown causes, and at present, the etiology and pathogenesis of PBC remain unclear. Nuclear receptor is a ligand-dependent transcription factor superfamily that regulates cell growth and differentiation by establishing a relationship between signal molecules and transcriptional responses. The human nuclear receptor family consists of 48 members, including peroxisome proliferator-activated receptors, pregnane X receptor, constitutive androstane receptor, liver X receptors, farnesoid X receptor, vitamin D receptor, and glucocorticoid receptor, which have attracted wide attention. These nuclear receptors regulate the key enzymes and transporter genes of bile acid metabolism at the transcriptional level and thus regulate the level of bile acid in the body and participate in inflammatory response. Bile acid metabolism disorder and persistent inflammation may be the key factors for the development and progression of PBC. This article reviews the research advances in nuclear receptors in the development and progression of PBC, in order to provide a theoretical basis for exploring the pathogenesis of PBC and new therapeutic targets.
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Primary biliary cholangitis (PBC) is an autoimmune cholestatic liver disease with unknown etiology. Liver biopsy is an important diagnostic tool, but its clinical application is limited due to its invasiveness. Autoantibodies have special diagnostic and prognostic value for PBC, especially anti-mitochondrial antibodies and antinuclear antibodies, and each antibody has unique clinical significance. This article reviews the diagnostic and prognostic significance of autoantibodies associated with PBC and related research advances.
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ObjectiveTo investigate the association of the expression of the NK cell-activating receptor NKG2D, its ligand major histocompatibility complex class I chain-related gene A (MICA), and related cytokines ［interferon-γ (IFN-γ), interleukin-10 (IL-10), and interleukin-15 (IL-15)］ with intrahepatic inflammation in primary biliary cholangitis (PBC). MethodsLiver biopsy specimens were collected from 30 patients with PBC (PBC group), 15 patients with chronic hepatitis B (CHB group), and 10 patients with nonalcoholic fatty liver disease (NAFLD group), who were hospitalized in The Second Affiliated Hospital of Kunming Medical University from August 2014 to June 2015. The degree of liver inflammation (G) and fibrosis degree (S) of the liver specimens were determined, and immunohistochemistry was used to measure the expression of NKG2D, MICA, IFN-γ, IL-10, and IL-15 in liver tissue (the scores were determined based on the number of cells stained and the degree of staining to evaluate the expression of each marker). A one-way analysis of variance was used for comparison of continuous data between multiple groups, and the t-test was used for comparison between two groups; a Spearman correlation analysis was used to investigate correlation. ResultsIn the PBC group, the expression of NKG2D increased with the degree of inflammation, and the patients with G3-4 inflammation had significantly higher expression than those with G1-2 inflammation (G1 vs G2 vs G3 vs G4: 1.4±0.05 vs 1.56±0.05 vs 1.86±0.11 vs 2.60±0.17, F=150.8, P＜0.05); the expression of NKG2D decreased with fibrosis degree (S3 vs S4: 2.30±0.17 vs 1.56±0.05, t=-1.52, P＜0.05). In the PBC group, there was no significant difference in MICA between G3 and G4 (0.11±0.01 vs 0.20±0.03, t=-2.20, P＞0.05) and between S3 and S4 (0.12±0.02 vs 0.18±0.03, t=-2.64, P＞0.05). In the PBC group, there was a significant difference in the expression of IL-15 between the patients with different degrees of inflammation (G1 vs G2 vs G3 vs G4: 0.70±0.10 vs 1.50±0.10 vs 1.93±0.11 vs 2.60±0.17, F=251.3, P＜0.05), while there was no significant difference between the patients with different fibrosis degrees (S3 vs S4: 2.00±0.05 vs 2.40±0.30, t=-1.62, P＞0.05). In the CHB group, there was a significant difference in the expression of IL-15 between the patients with different degrees of inflammation (G1 vs G2 vs G3: 0.73±0.15 vs 1.96±0.15 vs 2.50±0.17, F=150, P＜0.05) and between the patients with different fibrosis degrees (S1 vs S2 vs S3: 0.70±0.10 vs 21.96±0.15 vs 2.50±0.17, F=158.7, P＜0.05). In the PBC group, the expression of IL-10 was only observed in the patients with G1 inflammation (0.16±0.01), and in the CHB group, the expression of IL-10 was observed in the patients with G1 and G2 inflammation, with no significant difference (G1 vs G2: 0.19±0.01 vs 0.13±0.01, t=-1.522, P＞0.05). In the patients with PBC, the expression of IL-15 in liver tissue was positively correlated with the levels of alkaline phosphatase (ALP) and gamma-glutamyl transpeptidase (GGT) (r=0.241 and 0.407, P=0.014 and 0.045). ConclusionThe NK cell-activating receptor NKG2D affects the degree of intrahepatic inflammation in PBC, and the NKG2D ligand MICA is expressed in the advanced stage of PBC and can downregulate NKG2D. The expression of IL-15 increases with the degree of inflammation in PBC and is positively correlated with the levels of ALP and GGT, suggesting that the activation of NK cells and abnormal secretion of cytokines are involved in the development and progression of PBC and IL-15 may be used as an auxiliary index for the diagnosis of PBC.
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Primary biliary cholangitis (PBC) is an autoimmune-mediated chronic progressive liver disease and can progress to liver cirrhosis and liver cancer in the late stage. Clinical manifestations and complications of PBC have significant impact on patients’ mind and body, leading to the reduction in Health-related Quality of Life (HRQL). At present, HRQL has attracted more and more attention. This article summarizes the HRQL scales commonly used in China and foreign countries to assess HRQL in PBC patients and analyzes the main influencing factors for HRQL in PBC patients, in order to improve the treatment and monitoring of PBC patients in clinical practice.
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The bile duct is the channel for bile transport in the liver, and the lining epithelial cells in the bile duct have functional and morphological heterogeneity and are the target of various bile duct diseases. In addition to bile metabolism and secretion, biliary epithelial cells are also involved in tissue damage and repair. Biliary epithelial cells have an immune barrier function and can secrete different proinflammatory factors and chemokines. Under the stimulation of endogenous and exogenous factors, biliary epithelial cells present immune reactivity and initiate immune response in the host. This article reviews the current status of research on bile duct lesions and related liver diseases.
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Chenodeoxycholic acid (CDCA) is a primary bile acid and is involved in the digestion,transportation,and absorption of nutriments in the hepatobiliary system.Farnesoid X receptor (FXR) is a member of the nuclear receptor superfamily.In vivo and in vitro studies have demonstrated that CDCA is the natural ligand for FXR and involved in many cell signaling pathways,and it can inhibit the proliferation and induce the apoptosis of hepatobiliary tumor cells.This article reviews the association between CDCA and hepatobiliary tumor.
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The pathogenesis of primary biliary cholangitis (PBC) remains unclear.Ursodeoxycholic acid (UDCA) is currently the only drug approved by the Food and Drag Administration for the treatment of PBC,but some patients have a poor response to UDCA.New therapies can be considered for these patients.This article reviews the advances in drugs for PBC,including 6or-ethyl-chenodeoxycholic acid,fibrates,budesonide,and biological agents,and points out that these drugs bring new hope for PBC patients,but large-scale clinical studies are needed to confirm the long-term efficacy and safety.
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Objective To explore the clinical characteristics of patients with transjugular intrahepatic portosystemic shunt (TIPS) and literature review in patients with clinical features ,and provide clinical reference for carrying out the TIPS .Methods Totally 31 patients in our hospital from January 2009 to May 2014 who received TIPS treatment and strict follow‐up were retro‐spectively analyzed ,the preoperative basic situation ,laboratory index ,the incidence of postoperative bleeding again ,surgical compli‐cations ,the use of anticoagulant drugs and thrombosis ,dissolved ,etc .were statistical analyzed .Results In all patients with TIPS in the diagnosis of cirrhosis and portal hypertension ,hepatitis B ,hepatitis C cirrhosis and portal hypertension ,alcoholic liver cirrhosis and portal hypertension ,unknown cause of liver cirrhosis and portal hypertension ,Budd Chiari syndrome ,hepatitis B and hepatitis C cirrhosis and portal hypertension ,primary biliary cirrhosis and portal hypertension in proportion of 45 .16% ,16 .13% ,12 .90% , 12 .90% ,6 .45% ,3 .22% ,3 .22% respectively ;the incidence of postoperative bleeding again within six months was 9 .68% ;the Child‐Puhg score of preoperative and postoperative 1 week and 3 months ,6 months was (8 .35 ± 2 .52) ,(8 .32 ± 1 .76) ,(9 .29 ± 2 .55) ,(8 .10 ± 1 .85) respectively .Statistical results showed in postoperative 1 week and 3 months ,6 months ,there was no statisti‐cally significant difference compared with preoperative respectively (P>0 .05) ,postoperative 3 months liver function score of Child‐Puhg was higher than that of postoperative 1 week and 6 months (P<0 .05) operation;the rate of abdominal hemorrhage ,hepatic encephalopathy ,stent stenosis were 3 .22% ,22 .58% ,12 .90% ;the proportion of no postoperative taking anticoagulants ,taking as‐pirin ,clopidogrel ,and warfarin were 9 .68% ,38 .71% ,41 .94% ,9 .68% ,respectively ;the formation of portal vein thrombosis (inclu‐ding thrombosis increased) rate was 12 .90% ,thrombus dissolution rate was 100% .Conclusion In China ,liver cirrhosis and portal hypertension is the main source of TIPS and hepatitis B is a major cause of liver cirrhosis ;TIPS have no effect on liver function in Child‐Puhg score;hepatic encephalopathy ,stent restenosis is still the main postoperative complications of TIPS ;rules taking antico‐agulant drugs can dissolve thrombus of the portal vein and prevent thrombosis .
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Objective To investigate the effect of bone marrow mesenchymal stem cells (BMSCs) transplantation on expression of high mobility group box 1 protein (HMGB1) in rats with acute liver failure (ALF).Method SD rats were randomly divided into three groups:control group,ALF group and BMSCs transplantation group.Specimens were harvested in each group at 12 h,24 h and 72 h after ALF induction.Serum ALT and AST concentrations were determined,liver pathological changes were observed by HE staining,serum HMGB1 concentration detected by ELISA,and HMGB1 mRNA and protein in liver tissues examined by RT-PCR and immunohistochemistry respectively.Result The ALF models were successfully induced by D-GalN (900 rng/kg) and LPS (10 μg/kg) injection.Serum levels of ALT and AST in the ALF group were gradually increased with progression of the disease.As compared with the ALF group,significant improvement of liver function parameters and histological findings was observed in the transplantation group 72 h after transplantation (P＜0.01).The serum HMGB1 concentrations,the HMGB1 mRNA expression and the HMGB1 protein expression in liver tissue of control group were lowered at all time points,and they increased with time in the ALF group.After BMSCs transplantation,the serum HMGB1 concentrations,the HMGB1 mRNA and protein expression decreased with time.All the differences between ALF group and BMSCs transplantation group at 24 h and 72 h after transplantation were statistically significant (P＜0.01).At 24th h after transplantation,mortality rates of control group,ALF group,BMSC transplantation group were 0 (0/24),33.3％ (8/24) and 16.7％ (4/24) respectively with the difference being statistically significant (x2 =21.098,P＜ 0.01).Conclusion BMSCs transplantation can improve the liver function and pathological changes in rats with ALF,and decrease the expression of HMGB1.
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BACKGROUND:Studies have shown that the main functions of mesenchymal stem cels include direct participation in wound healing, growth factor secretion, promoting angiogenesis, immune regulation and inflammation, anti-oxidative stress, which can be used to treat a variety of acute and chronic diseases. OBJECTIVE:To review advances in mesenchymal stem cels in the inflammatory immunomodulation. METHODS: A computer-based search of Wanfang, CNKI and PubMed databases was performed for articles concerning advances in mesenchymal stem cels in the inflammatory immunomodulation published from January 2005 to August 2015. The search terms were “stem cels, mesenchymal stem cels, immune regulation, inflammation, immune cels, inflammatory factors, treatment” in Chinese and English, respectively. Finaly, 40 articles were included in result analysis. RESULTS AND CONCLUSION:Because of their immunomodulation and muti-directional differentiation, mesenchymal stem cels garner increasing attentions. In addition, mesenchymal stem cels can be harvested from different tissues and have goodin vitroamplification capability, which have a broad prospect in the clinical use, including tissue repair and anti-inflammation. As the most promising cels used clinicaly, mesenchymal stem cels show their superiority in the treatment of many diseases, especialy in inflammations induced by immune modulation imbalance. We believe that mesenchymal stem cels wil play an important role in the future cel biotherapy.
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<p><b>OBJECTIVE</b>To compare frequencies of natural killer (NK) cell subsets and their surface expression of the NKG2D receptor in patients with primary biliary cirrhosis (PBC), and to determine the correlation between expression of MICA on monocytes and function-associated receptors on the NK cells of PBC patients.</p><p><b>METHODS</b>Twenty patients with PBC and 18 healthy donors were included in the study. Peripheral blood samples anticoagulated with heparin were labeled with the following antibody combinations: anti-CD45/anti-CD14/anti-MICA, antiCD3/anti-CD56/anti-CD16/anti-NKG2D. Frequencies of MICA-positive monocytes, NK cell subsets, and NK cells with surface expression of NKG2D were measured with flow cytometry. Correlation of MICA expression on monocytes with NKG2D expreesion on NK cells was assessed through linear correlation and regression analysis.</p><p><b>RESULTS</b>The PBC patients had significantly lower percentages of NK cells than the healthy donors (6.8%+/-2.9% vs.16.4%+/-3.4%, P =0.000<0.05). In the PBC patients, the percentage of CD56-positive NK ceils was significantly higher than that of CD16-positive NK cells (4.2%+/-2.8% vs.1.4%+/-0.7%, P=0.003<0.05). The PBC patients also had significantly higher percentage of NKG2D surface expressing CD56-positive NK cells than the healthy donors (79.4%+/-10.2% vs.64.8%+/-10.7%, P=0.000<0.05). The PBC patients and healthy donors showed no statistically significant differences in percentages of NKG2D surface expressing CDl6-positive NK (70.1%+/-12.9% vs.61.1%+/-5.9%, P=0.078>0.05). MICA was seldom detected on normal monocytes (2.6%+/-1.9%), but present for 51.6%+/-16.2% of monoeytes from the PBC patients (P =0.000<0.05). There was a significant difference in frequency of CD14/MICA double-positive monocytes between the healthy donors and PBC patients. No correlation of MICA expression on monocytes with NKG2D expression on NK cells was found.</p><p><b>CONCLUSION</b>PBC patients have lower levels of NK cells in peripheral blood than their healthy counterparts. PBC patients also have higher levels of the CD56+ NK cell subset and cells with surface expression of the activated NKG2D receptor. It appears that PBC patients have a greater level of CD14+MICA+ peripheral blood mononuclear cells. NK cells may be affected by the PBC-related monocytes and participate in disease pathogenesis through immune regulation.</p>
Subject(s)
Humans , Flow Cytometry , Killer Cells, Natural , Liver Cirrhosis, Biliary , NK Cell Lectin-Like Receptor Subfamily KABSTRACT
ObJective To explore the value of acute physiology and chronic health evaluation Ⅲ(APACHE Ⅲ ) score and the concentration of serum cholinesterase (ChE) in predicting the condition and prognosis of patients with severe acute pancreatitis (SAP) within 24 hours afar hospitalization.Methods Sixty-two SAP patients were enrolled and APACHE Ⅲ score was assessed and the concentration of serum ChE was detected within 24 hours after hospitalization.The correlation between the concentration of serum ChE,APACHE Ⅲ score and the condition and prognosis was analyzed.Results There were 44 survivalcases and 18 dead cases.The APACHE Ⅲ score of the surval patients was significantly lower than that of the dead patients [(52.16 ± 13.76) scores vs.(97.10 ± 15.85) scores] (P＜0.01).The concentration of serum ChE of survival patients was significantly higher than that of the dead patients [ (3685 ± 466) U/L vs.(2109 ± 345) U/L] (P＜ 0.01 ).The higher APACHE Ⅲ score was,the lower the serum ChE concentration was,and the higher the mortality rate was.APACHE Ⅲ score and the concontration of serum ChE both had statistical significances compared with the prognosis in the Logistic regression analysis (P =0.0043,0.0075);APACHE Ⅲ score (95％ CI 1.0306-1.1507),the concentration of serum ChE (95％ CI0.9986-1.0125 ).ROC areas under curve (AUC) of APACHE Ⅲ score,serum ChE concentration with the prognosis were 0.936 and 0.882,respectively.There was no significant difference (P=0.0820).In combined prediction of APACHE Ⅲ score and serum ChE concentration,AUC was 0.952,and its predicting accuracy was higher than either APACHE Ⅲ score or serum ChE concentration (P=0.0016,0.0027).Conclusions APACHE Ⅲ score and the concentration of serum ChE both are significantly correlated with the condition and prognosis of SAP patients.Their combined detection can significantly improve the accuracy of prognosis judgement and provide some clinical guidances for treatment.
