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| 血清LRG1 sCD40L I-FABP对急性阑尾炎患者病情严重程度及术后胃肠功能恢复的预测价值 |
| The predictive value of serum LRG1, sCD40L, and I-FABP for severity of acute appendicitis and postoperative gastrointestinal function recovery in patients |
| 投稿时间：2025-01-13 |
| DOI：10.3969/j.issn.1000-0399.2025.12.006 |
| 中文关键词: 急性阑尾炎 富含亮氨酸α-2糖蛋白1 可溶性CD40配体 肠型脂肪酸结合蛋白 严重程度 胃肠功能恢复 |
| 英文关键词: Acute appendicitis Leucine-rich alpha-2 glycoprotein 1 Soluble CD40 ligand Intestinal-fatty acid binding protein Disease severity Gastrointestinal function recovery |
| 基金项目:河北省2024年度中医药类科学研究课题计划项目(编号:2024133) |
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| 中文摘要: |
| 目的 探究血清富含亮氨酸α-2糖蛋白1(LRG1)、可溶性CD40配体（sCD40L）、肠型脂肪酸结合蛋白（I-FABP）对急性阑尾炎患者病情严重程度及术后胃肠功能恢复的预测价值。方法 选择2021年5月至2024年5月于石家庄市妇幼保健院行腹腔镜阑尾切除术的205例急性阑尾炎患者为研究组，根据病情严重程度分为急性单纯性阑尾炎（单纯组）104例、急性化脓性阑尾炎（化脓组）56例和急性坏疽性阑尾炎（坏疽组）45例，根据术后胃肠功能恢复情况分为恢复良好组158例和恢复不良组47例。另选择同期205例于本院体检结果健康者为对照组。采用酶联免疫吸附法（ELISA）检测各组血清LRG1、sCD40L、I-FABP表达。Pearson法分析血清LRG1、sCD40L、I-FABP与急性阑尾炎患者术后胃肠功能恢复指标的相关性。Spearman法分析血清LRG1、sCD40L、I-FABP与急性阑尾炎患者病情程度的相关性。绘制受试者工作特征（ROC）曲线分析LRG1、sCD40L、I-FABP对术后胃肠功能恢复不良的预测价值。结果 研究组血清LRG1、sCD40L、I-FABP表达均高于对照组（P<0.05）。随着病情的加重，单纯组、化脓组、坏疽组血清LRG1、sCD40L、I-FABP表达均呈上升趋势（P<0.05）。恢复不良组肠鸣音恢复正常时间、首次排气时间、首次排便时间、病情程度（坏疽组）占比均高于恢复良好组（P<0.05），血清LRG1、sCD40L、I-FABP表达高于恢复良好组（P<0.05）。急性阑尾炎患者血清LRG1、sCD40L、I-FABP与肠鸣音恢复正常时间、首次排气时间、首次排便时间、病情程度呈正相关（P<0.05）。LRG1、sCD40L、I-FABP联合预测急性阑尾炎患者术后胃肠功能恢复不良的曲线下面积为0.937，大于LRG1(Z=2.980,P=0.003)、sCD40L(Z=2.758,P=0.006)、IFABP(Z=2.229,P=0.026)单独预测。急性阑尾炎患者术后血清LRG1、sCD40L、I-FABP表达均低于术前（P<0.05）。结论 急性阑尾炎患者血清LRG1、sCD40L、I-FABP表达与病情严重程度相关，3者联合对患者术后胃肠功能恢复具有一定评估价值。 |
| 英文摘要: |
| Objective To investigate the predictive value of serum leucine-rich alpha-2 glycoprotein 1（LRG1）, soluble CD40 ligand（sCD40L）, and intestinal-fatty acid binding protein（I-FABP） for the severity of acute appendicitis and postoperative gastrointestinal function recovery in patients. Methods This study selected 205 patients with acute appendicitis who underwent laparoscopic appendectomy in our hospital from May 2021 to May 2024 as the research group. According to the severity of the condition, they were assigned into four groups: 104 cases of acute simple appendicitis（simple group）, 56 cases of acute suppurative appendicitis（suppurative group）, and 45 cases of acute gangrenous appendicitis（gangrene group）. Based on the postoperative recovery of gastrointestinal function, they were assigned into 158 cases in the good recovery group and 47 cases in the poor recovery group. Meantime, another 205 healthy individuals who underwent physical check ups at our hospital were included as the control group. Enzyme linked immunosorbent assay（ELISA） was applied to detect the expression of serum LRG1, sCD40L, and I-FABP. Pearson method was applied to analyze the correlation between serum LRG1, sCD40L, I-FABP and postoperative gastrointestinal function recovery indicators in patients. Spearman correlation analysis was conducted to assess the association between serum LRG1, sCD40L, and I-FABP levels and disease severity in patients with acute appendicitis. Receiver operating characteristic（ROC） curves were plotted to analyze the predictive value of LRG1, sCD40L, and I-FABP for postoperative gastrointestinal dysfunction. Results The expressions of serum LRG1,sCD40L and I-FABP in the study group were all higher than those in the control group（P ＜0.05）. With the aggravation of the disease, the expressions of serum LRG1,sCD40L and I-FABP in the simple group, suppurative group and gangrene group all showed an upward trend（P ＜0.05）. The time for bowel sounds to return to normal, the time for the first exhaust, the time for the first defecation, and severity of illness（gangrene group） were all higher in the poor recovery group than in the good recovery group（P ＜0.05）, and the expressions of serum LRG1, sCD40L, and I-FABP were higher than those in the good recovery group（P ＜0.05）. The serum levels of LRG1, sCD40L, and IFABP in patients with acute appendicitis were positively correlated with the time for bowel sounds to return to normal, first exhaust time, first defecation time, and severity of illness（P ＜0.05）. The area under the curve of the combination of LRG1, sCD40L, and I-FABP in predicting postoperative gastrointestinal dysfunction in patients with acute appendicitis was 0.937, greatly larger than the area under the curve predicted by LRG1（Z=2.980, P=0.003）, sCD40L（Z=2.758, P=0.006）, and I-FABP（Z=2.229, P=0.026） separately. The expression of serum LRG1, sCD40L, and I-FABP in patients with acute appendicitis after surgery was lower than that before surgery（P ＜0.05）. Conclusion The expression of serum LRG1, sCD40L, and I-FABP is related to the severity of the disease, and the combination of the three has certain value in evaluating postoperative gastrointestinal function recovery. |
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