Relationship of Serum ACE2,ApoB/A1 Ratio with Severity and Prognosis of Acute Pancreatitis in Children

WANG Gai; HOU Mengyan

doi:10.3969/j.issn.1002-3429.2024.04.012

Abstract：Objective To investigate the relationship of serum angiotensin converting enzyme 2(ACE2)and Apoli-poprotein B/A1(ApoB/A1)ratio with the severity and prognosis of acute pancreatitis(AP)in children.Methods From April 2021 to October 2023,116 children with AP were selected,including 69 children with mild and moderate AP and 47 children with severe AP.The serum ACE2,ApoB/A1 ratio and the scores related to the severity of the disease[bedside index for severity in acute pancreatitis(BISAP)score,Ranson scoring,Acute Physiology and Chronic Health Status Score System Ⅱ(APACHE Ⅱ)]were compared in children with different severity levels.The correlation between serum ACE2,ApoB/A1 ratio and the score of disease severity was analyzed.The prognosis of 116 children with AP was analyzed,and the serum ACE2 and ApoB/A1 ratio of children with different prognosis were compared.The influence of serum ACE2 and ApoB/A1 ratios on the risk of adverse prognosis of AP children was analyzed by relative risk degree.Receiver operating characteristic(ROC)curve was used to evaluate the prognostic value of serum ACE2 and ApoB/A1 ratio in children with AP.Results The serum ACE2 level in mild and moderate group was higher than that in severe group,while the ApoB/A1 ratio and the scores of BISAP,Ranson and APACHE Ⅱ were lower than those in severe patients(P<0.01).Pearson correlation analysis showed that the serum ACE2 level of AP children was negatively correlated with the scores of BISAP,APACHE Ⅱ and Ran-son,and that the ApoB/A1 ratio was positively correlated with the scores of BISAP,Ranson and APACHEⅡ(P<0.01).The serum ApoB/A1 ratio in children with poor prognosis was higher than that in children with good prognosis,while the level of ACE2 was lower than that in children with good prognosis(P<0.05).The risk of adverse prognosis was 4.667(95％CI:1.416,15.380)times higher in the low level of serum ACE2 subgroup than in the high level subgroup.The risk of poor prog-nosis in the high ApoB/A1 ratio subgroup was 3.250(95％CI:1.126,9.380)times that in the low ApoB/A1 ratio sub-group.ROC curve showed that the area under the ROC curve of combining serum ACE2 and ApoB/A1 ratio to predict the prognosis of AP children was 0.927,which was significantly higher than that predicted by each indicator alone.Conclusion Serum ACE2 and ApoB/A1 ratio is significantly correlated with the disease severity of AP children,and the combined detec-tion of the two indexes has a good prognostic value for AP children.