Expression and clinical significance of serum CaMK Ⅱ and PLD2 in patients with severe acute pancreatitis complicat-ed by sepsis

Ye Liqizhen; Chen Xinyu; Wang Jinna; Han Shuangshuang; Yang Chunbo

doi:10.3969/j.issn.1671-6450.2026.03.006

Abstract：Objective To investigate the expression and clinical significance of serum calcium/calmodulin-dependent protein kinase Ⅱ(CaMK Ⅱ)and phospholipase D2(PLD2)in patients with severe acute pancreatitis(SAP)complicated by sepsis.Methods A total of 105 patients with SAP complicated by sepsis admitted to the Intensive Care Unit,First Affiliated Hospital of Xinjiang Medical University,from January 2021 to January 2025 were prospectively enrolled as the sepsis group.According to disease severity,they were divided into the general sepsis subgroup(n=45)and the septic shock subgroup(n=60).Based on 90-day outcomes,patients were further divided into the death subgroup(n=41)and survival subgroup(n=64).Another 105 SAP patients without sepsis,matched 1∶1 during the same period,were included as the non-sepsis group.Serum CaMKⅡ and PLD2 levels were measured by enzyme-linked immunosorbent assay.The relationship between serum CaMK Ⅱand PLD2 levels and disease severity in SAP patients with sepsis was analyzed using point-biserial correlation analysis.Multi-variate logistic regression analysis was used to analyze the influencing factors of prognosis and death in patients with SAP complicated with sepsis.Receiver operating characteristic(ROC)curve analysis was used to evaluate the predictive efficacy of serum CaMK Ⅱ and PLD2 levels on the prognosis and death of patients with SAP complicated with sepsis.Results Serum CaMKⅡ and PLD2 levels were significantly higher in the sepsis group than in the non-sepsis group(t/P=10.109/＜0.001 and 9.100/＜0.001,respectively).Patients in the septic shock subgroup had higher serum CaMKⅡ and PLD2 levels than those in the general sepsis subgroup(t/P=5.458/＜0.001 and 5.503/＜0.001,respectively).Point-biserial correlation analysis revealed that serum CaMKⅡ and PLD2 levels were positively correlated with disease severity in SAP patients with sepsis(r/P=0.574/＜0.001 and 0.563/＜0.001,respectively).The death subgroup had higher proportions of septic shock,sequential organ failure as-sessment(SOFA)scores,acute physiology and chronic health evaluation Ⅱ(APACHE Ⅱ)scores,and serum CaMK Ⅱ and PLD2 levels than the survival subgroup(t/P=3.622/＜0.001,3.355/0.001,12.005/＜0.001,6.036/＜0.001,and 5.419/＜0.001,re-spectively).Multivariate logistic regression identified septic shock,higher SOFA and APACHE Ⅱ scores,and elevated CaMKⅡ and PLD2 levels as independent risk factors for mortality in SAP patients with sepsis[OR(95％CI)=4.708(1.076-20.599),1.436(1.097-1.880),1.237(1.088-1.405),1.037(1.016-1.059),and 1.046(1.016-1.077),respectively].The areas under the ROC curves(AUCs)for serum CaMK Ⅱ,PLD2,and their combination in predicting mortality were 0.795,0.782,and 0.907,respectively.The combined detection showed significantly higher predictive performance than either marker alone(Z/P=2.990/0.003 and 3.141/0.002).Conclusion Elevated serum CaMKⅡ and PLD2 levels are closely associated with dis-ease progression in SAP patients complicated by sepsis.The combined measurement of serum CaMK Ⅱ and PLD2 provides high predictive value for mortality in these patients.