探讨急性高脂血症性胰腺炎（HLAP）患者中血清chemerin、降钙素原（PCT）水平变化及临床意义。

入选2016年1月至2018年7月在宿迁市第一人民医院住院的82例HLAP患者，按其病情程度分为重症急性胰腺炎(SAP)组（34例）、轻症急性胰腺炎(MAP)组（48例），以50例体检健康者作为健康对照组。应用酶联免疫吸附试验法检测血清chemerin水平，采用荧光酶标免疫测试仪测定血清PCT水平。应用t检验对健康对照者和MAP组、SAP组患者的血清chemerin、PCT水平，HLAP死亡患者和未死亡患者的血清chemerin、PCT水平进行组间比较。应用Pearson法对HLAP患者血清chemerin、PCT水平的相关性，HLAP患者血清chemerin、PCT水平与血生化指标、AP严重程度的相关性进行分析。

健康对照者和MAP组、SAP组患者血清chemerin水平依次增高［（303.7±106.9）μg/L、（472.9 ± 158.6）μg/L、（653.4±229.3）μg/L］，两两比较差异均具有统计学意义（P均<0.01）。健康对照组、MAP组、SAP组血清PCT水平依次增高［（1.78±0.95）μg/L、（5.29±2.54）μg/L、（8.21±4.23）μg/L］，两两比较差异均具有统计学意义（P均<0.01）。HLAP患者血清chemerin水平和PCT水平呈正相关（r=0.325，P=0.018）。HLAP患者血清chemerin水平与血TG、总胆固醇、CRP水平呈正相关（r=0.521，0.378，0.423，P=0.003，0.005，0.005），与血淀粉酶、乳酸脱氢酶无相关性（r=0.154、0.215，P均>0.05）；血清PCT水平与血CRP、乳酸脱氢酶呈正相关（r=0.420，0.430，P=0.004，0.004），与血TG、总胆固醇、淀粉酶无相关性（r=0.182，0.144，0.210，P均>0.05）。HLAP患者血清chemerin水平与24 h急性生理与慢性健康评分（APACHE）Ⅱ、Ranson评分呈正相关（r=0.370、0.428，P=0.024，0.013）；血清PCT水平与24 h APACHE Ⅱ、Ranson评分呈正相关（r=0.376、0.320，P=0.018，0.021）。SAP组死亡患者6例，死亡患者血清chemerin、PCT水平与未死亡患者比较［（770.6±182.3）μg/L vs （678.3±246.5）μg/L，（10.60±3.87）μg/L vs （7.45±3.58）μg/L］，差异无统计学意义（P均>0.05）。

HLAP患者血清chemerin、PCT水平显著升高，且与病情严重程度呈正相关。血清chemerin和PCT可作为潜在的评估HLAP患者病情严重程度的指标。

To investigate the serum levels of chemerin and procalcitonin (PCT) in patients with hyperlipidemic acute pancreatitis (HLAP), and to explore their changes and significance.

A total of 82 HLAP patients admitted to the First People′s Hospital of Suqian from January 2016 to July 2018 were selected. The patients were classified into severe acute pancreatitis (SAP) patients (34 cases) and mild acute pancreatitis (MAP) patients (48 cases). Fifty healthy adults were included as a healthy control group. Serum levels of chemerin were measured using an ELISA kit, and the levels of PCT were measured by immunoassay. The t-test was used to compare serum chemerin and PCT between the healthy control group, MAP group, and SAP group, as well as between the death and non-death groups. Pearson method was used to analyze the correlation between serum chemerin and PCT, as well as between serum chemerin or PCT and blood biochemical indicators or the severity of acute pancreatitis.

Compared with the healthy control group [(303.7±106.9) μg/L], serum chemerin level significantly increased in the MAP group [(472.9 ± 158.6) μg/L] and SAP group [(653.4±229.3) μg/L], and pairwise comparisons were statistically significant (P<0.01). Compared with the healthy control group [(1.78±0.95) μg/L], serum PCT also increased significantly in the MAP group [(5.29±2.54) μg/L] and SAP group [(8.21±4.23) μg/L], and pairwise comparisons were statistically significant (P<0.01). Serum levels of chemerin were positively correlated with those of PCT (r=0.325, P=0.018). Serum level of chemerin were positively correlated with serum levels of TG, total cholesterol, and CRP (r=0.521, 0.378, 0.423, P=0.003, 0.005, 0.005), but had no correlation with serum amylase or lactate dehydrogenase (r=0.154、0.215, P>0.05); Serum levels of PCT were positively correlated with serum levels of CRP and lactate dehydrogenase (r=0.420, 0.430, P=0.004, 0.004), but had no correlation with serum TG, total cholesterol, and amylase (r=0.182, 0.144, 0.210, P>0.05). Serum levels of chemerin and PCT were both positively correlated with APACHE II and Ranson score (r=0.370, 0.428, P=0.024, 0.013; r=0.376, 0.320, P=0.018, 0.021). Six patients died of SAP. There was no significant difference in chemerin or PCT level between the dead patients and non-dead patients [(770.6±182.3) μg/L vs (678.3±246.5) μg/L, (10.60±3.87) μg/L vs (7.45±3.58) μg/L, P>0.05].

In HLAP patients, serum chemerin and PCT levels significantly increase and positively correlate with disease severity. These results suggest that chemerin and PCT may act as potential serum markers for HLAP severity evaluation.