儿科胰腺炎中急性损伤标志物:区分疾病状态和评估严重程度
Vineet Garlapally1, Xiaojia Guo2, Lindsey Hornung3
1Division of Gastroenterology, Hepatology and Nutrition, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA.
Journal of pediatric gastroenterology and nutrition
|December 12, 2025
概括
像损伤分子-1 (KIM-1) 和囊-C (CYS-C) 这样的新生物标志物可以帮助区分儿科急性胰腺炎 (AP) 和慢性胰腺炎 (CP). 这些生物标志物和尿NGAL (uNGAL) 的水平升高表明AP患者的损伤.
科学领域:
- 儿科脏病学 儿科脏病学
- 胃肠病学 胃肠病学
- 生物标志物发现发现
背景情况:
- 急性损伤 (AKI) 是成人急性胰腺炎 (AP) 的已知并发症,但其在儿科患者中的发生和检测知之甚少.
- 在儿科AP和慢性胰腺炎 (CP) 中,特定AKI生物标志物的诊断效用需要进一步研究.
研究的目的:
- 评估损伤分子-1 (KIM-1),利波卡林2 (NGAL),囊素-C (CYS-C) 和再生酶 (RNLS) 作为AKI生物标志物的有效性,用于患有AP和CP的儿科患者.
- 使用这些生物标志物来评估AP的严重程度和整体功能.
主要方法:
- 从被诊断为AP (n=49),CP (n=50) 和健康对照组 (HC; n=20) 的儿童收集了血和尿液样本.
- 使用酶相关免疫吸收试验 (ELISA) 测量生物标志物水平.
- 通过血肌素 (pCre) 和基于CYS-C的增强膜过率 (eGFR) 公式评估功能.
主要成果:
- 与CP和HC相比,血KIM-1和pCYS-C在AP显著增加 (p<0.0001).与CP和HC相比,AP显著增加 (p<0.0001).
- 尿中NGAL (uNGAL) 在AP患者中升高;14%超过125 ng/mL.
- 血CYS-C,pA-RNLS和pF-RNLS显示出区分AP和CP的预测能力 (AUC=0.86).
- 中度/重度AP (SAP) 患者的pKIM-1和pCYS-C水平高于轻度AP (MAP) 患者.
结论:
- 血KIM-1,pCYS-C和uNGAL的升高,以及pF-RNLS的降低,是区分儿科AP和CP的有价值指标.
- 在48小时内量化血KIM-1和pCYS-C可能有助于预测SAP的发展.
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