Authors

Hongtao Mao, Yang Li, Yang Hu#

Departments

The First Affiliated Hospital of Nanchang University, Nanchang, PR China

Abstract

Objective: To study the changes in serum high mobility group box 1 (HMGB1), heat shock protein 70 (HSP70), Ghrelin and Visfatin levels and analyse the clinical significance of these changes in patients with severe acute pancreatitis. 

Methods: The treatment group includes 40 patients with acute pancreatitis (AP) and 46 patients with severe acute pancreatitis (SAP) who were admitted to our hospital from July 2018 to July 2019. 40 healthy people attending the physical examination centre during the same period were selected as the control group. The levels of HMGB1, HSP70, Ghrelin and Visfatin in both AP and SAP patients were recorded on the first day of admission, and on the second, fourth and sixth day after treatment. These results were compared with the results of the healthy subjects within the control group. Patients with severe acute pancreatitis were divided into the survival group (n=34) and the death group (n=12) according to their prognosis. A comparative analysis was carried out regarding the differences in HMGB1, HSP70, Ghrelin and Visfatin levels in patients with different prognoses. The values of HMGB1, HSP70, Ghrelin and Visfatin in those with a diagnosis of severe acute pancreatitis were analysed using a ROC curve. 

Results: The levels of HMGB1, HSP70, Ghrelin and Visfatin in both the AP and SAP groups were higher than those in the control group. The levels in the SAP group were higher than those in the AP group, resulting in a statistically significant difference (P<0.05). The levels of HMGB1, HSP70, Ghrelin and Visfatin decreased after treatment in AP patients, and again, the differences both within groups and between groups were statistically significant (P<0.05). The HMGB1, HSP70, Ghrelin and Visfatin levels in the death group were higher than those in the survival group, also demonstrating statistically significant differences (P<0.05). The ROC curve model found that the areas under the curve of HMGB1, HSP70, Ghrelin, Visfatin and HMGB1+HSP70+Ghrelin+Visfatin were 0.82, 0.79, 0.74, 0.71, and 0.91, respectively. The predicted value of the four levels combined was significantly higher than that of a single level. 

Conclusion: The levels of HMGB1, HSP70, Ghrelin and Visfatin in patients with different severities of AP vary, as do the levels in SAP patients with alternative prognoses. The above indicators alone or in combination, can be used as an effective way to diagnose SAP, and can also be used as an observational indicator to evaluate the prognosis of patients. The prediction that results from the four indicators combined is of higher diagnostic value. 

Keywords

Severe acute pancreatitis, high mobility group box 1, heat shock protein 70, ghrelin, visfatin.

DOI:

10.19193/0393-6384_2020_3_239