2025 年第 1 期 第 0 卷

重症急性胰腺炎并发脓毒症患者血清再生家庭成员3α和Orai钙释放激活钙调节剂1水平的变化及对预后的预测价值

Changes of serum regenerative family member 3α and Orai calcium release-activated calcium regulator 1 levels in patients with severe acute pancreatitis complicated with sepsis and their predictive value for prognosis

作者：陈文凤  殷锐  黄海容  张琴  罗静  邹盛婷

英文作者：Chen Wenfeng Yin Rui Huang Hairong Zhang Qin Luo Jing Zou Shengting

单位：重庆大学附属肿瘤医院巴南分院重庆市巴南区第二人民医院急诊科，重庆401345

英文单位：Department of Emergency Banan Branch of Chongqing University Cancer Hospital Banan District Second People′s Hospital of Chongqing Chongqing 401345 China

关键词：重症急性胰腺炎；  脓毒症；  再生家庭成员3α；  Orai钙释放激活钙调节剂1；  预后

英文关键词：Severeacutepancreatitis;  Sepsis;  Regenerativefamilymember3α;  Oraicalciumrelease-activatedcalciumregulator1;  Prognosis

• 摘要：

• 目的  探讨重症急性胰腺炎（SAP）并发脓毒症患者血清再生家庭成员3α（REG3A）和Orai钙释放激活钙调节剂1（ORAI1）水平的变化及对预后的预测价值。方法  选取2021年1月至2023年11月重庆大学附属肿瘤医院巴南分院收治的SAP并发脓毒症患者175例为脓毒症组，另选取本院同期未并发脓毒症的SAP患者90例为非脓毒症组。脓毒症组根据90 d预后分为死亡组和存活组。采用酶联免疫吸附试验法检测血清REG3A、ORAI1水平。进行SAP并发脓毒症患者死亡的单因素分析，而后以SAP并发脓毒症患者死亡为因变量，建立多因素非条件Logistic回归模型分析其影响因素；绘制受试者工作特征曲线评价血清REG3A、ORAI1水平预测SAP并发脓毒症患者死亡的价值。结果  本研究无脱落患者。脓毒症组血清REG3A、ORAI1水平高于非脓毒症组［（20.3±4.6）μg/L比（14.4±2.6）μg/L、（39±9）μg/L比（25±6）μg/L］（t＝13.457、16.481，均P＜0.001）。单因素分析结果显示，病情程度、序贯器官衰竭评估（SOFA）评分、急性生理学与慢性健康状况评分系统Ⅱ（APACHEⅡ）评分、降钙素原、REG3A、ORAI1与SAP并发脓毒症患者死亡有关（均P＜0.05）。多因素非条件Logistic回归模型分析结果显示脓毒性休克、SOFA评分增加、APACHEⅡ评分增加、REG3A升高和ORAI1升高为SAP并发脓毒症患者死亡的独立危险因素（比值比=8.105、1.321、1.317、1.540和1.274，均P＜0.05）。血清REG3A联合ORAI1水平预测SAP并发脓毒症患者死亡的曲线下面积为0.893，大于血清REG3A、ORAI1水平单独预测的0.780、0.783（Z=3.990、3.770，均P＜0.001）。结论  SAP并发脓毒症患者血清REG3A、ORAI1水平升高，且这种变化是死亡的独立危险因素。血清REG3A联合ORAI1水平预测SAP并发脓毒症患者预后的价值较高。

• Objective  To investigate the changes of serum regenerative family member 3α (REG3A) and Orai calcium release-activated calcium regulator 1 (ORAI1) levels in patients with severe acute pancreatitis (SAP) complicated with sepsis and their predictive value for prognosis. Methods   A total of 175 SAP patients complicated with sepsis admitted to Banan Branch of Chongqing University Cancer Hospital from January 2021 to November 2023 were selected as the sepsis group, and 90 SAP patients without sepsis in the same hospital during the same period were selected as the non-sepsis group. The sepsis group was divided into death group and survival group according to the 90-day prognosis. Serum REG3A and ORAI1 levels were detected by enzyme-linked immunosorbent assay. Univariate analysis was performed on the death of SAP patients complicated with sepsis, and then multivariate unconditional Logistic regression model was established to analyze the influencing factors with the death of SAP patients complicated with sepsis as the dependent variable. Receiver operating characteristic curve was drawn to evaluate the value of serum REG3A and ORAI1 levels in predicting the death of SAP patients with sepsis. Results   No patients dropped out of this study. The levels of serum REG3A and ORAI1 in sepsis group were higher than those in non-sepsis group［(20.3±4.6)μg/L vs (14.4±2.6)μg/L, (39±9)μg/L vs (25±6)μg/L］(t=13.457, 16.481, both P<0.001). Univariate analysis showed that the severity of disease, sequential organ failure assessment score, acute physiology and chronic health evaluation Ⅱ score, procalcitonin, REG3A and ORAI1 were related to the death of SAP patients with sepsis(all P<0.05). Multivariate unconditional Logistic regression model analysis showed that septic shock, increased sequential organ failure assessment score, increased acute physiology and chronic health evaluation Ⅱ score, increased REG3A and ORAI1 were independent risk factors for death in SAP patients with sepsis(odds ratios=8.105, 1.321, 1.317, 1.540, 1.274, all P<0.05). The area under the curve of serum REG3A combined with ORAI1 for predicting the death of SAP patients with sepsis was 0.893, which was larger than 0.780 and 0.783 of serum REG3A and ORAI1 levels alone(Z=3.990, 3.770, both P<0.001). Conclusion   Serum REG3A and ORAI1 levels are increased in SAP patients with sepsis, and these changes are independent risk factors for death. Serum REG3A combined with ORAI1 levels have a high value in predicting the prognosis of SAP patients with sepsis.