关键词: 重症急性胰腺炎, 急性肾损伤, 单核细胞趋化蛋白-1, NOD样受体蛋白3, 预测

Abstract: Objective To investigate the changes in the expression levels of serum monocyte chemotactic protein-1 (MCP-1) and NOD like receptor protein-3 (NLRP3) in patients with severe acute pancreatitis complicated by acute kidney injury,and the early predictive value of the combination of the two for diseases.Methods A total of 105 patients with severe acute pancreatitis from May 2022 to May 2024 were selected as the observation group.They were separated into a non concurrent group of 69 cases and a concurrent group of 36 cases based on whether acute kidney injury was present.According to the severity of acute kidney injury,they were further grouped into a mild group of 15 cases,a moderate group of 12 cases,and a severe group of 9 cases.Additionally,105 healthy volunteers who underwent physical examination were regarded as the control group.Enzyme linked immunosorbent assay (ELISA) was applied to detect the expression levels of serum MCP-1 and NLRP3.Multi factor Logistic analysis was applied to analyze the influencing factors of acute kidney injury in patients with severe acute pancreatitis.Receiver operating characteristic (ROC) curve was plotted to analyze the predictive value of serum MCP-1 and NLRP3 levels in predicting acute kidney injury in patients with severe acute pancreatitis.Results Serum MCP-1 and NLRP3 expression levels in the control group were (118.24±24.68) μg/L and (267.42±61.24) μg/L,respectively,while those in the observation group were (407.46±101.73) μg/L and (603.23±164.51) μg/L,respectively,with statistically significant differences between the two groups (P<0.05).In the concurrent group,serum MCP-1 and NLRP3 levels were (482.59±102.99) μg/L and (755.33±143.73) μg/L,respectively,compared with (368.26±76.29) μg/L and (523.88±110.10) μg/L in the non concurrent group,showing statistically significant differences (P<0.05).As the severity of acute kidney injury progressed,the serum MCP-1 expression levels in the mild,moderate,and severe groups were (378.23±48.08) μg/L,(521.22±39.52) μg/L,and (605.03±26.20) μg/L,respectively;The expression levels of serum MCP-1 were (629.89±67.88) μg/L,(764.99±45.26) μ g/L,and (951.52±80.97) μg/L,respectively,all of which increased in sequence with statistically significant differences.Multivariate Logistic analysis showed that creatinine,MCP-1,and NLRP3 were risk factors for severe acute pancreatitis complicated with acute kidney injury (P<0.05).ROC results showed that the area under the curve (AUC) value of serum MCP-1 and NLRP3 levels combined to predict acute kidney injury in patients with severe acute pancreatitis was 0.943.Conclusion The expression levels of serum MCP-1 and NLRP3 are elevated in patients with severe acute pancreatitis complicated by acute kidney injury,and the combination of the two has a higher efficacy in early prediction of acute kidney injury.

Key words: severe acute pancreatitis, acute kidney injury, monocyte chemotactic protein-1, NOD like receptor protein 3, prediction