Clinical Study On The Correlation Between Human Serum Amyloid A Level And The Severity Of Acute Pancreatitis

Objective: This study is aimed to evaluate the serum amyloid A(SAA)level in patient with acute pancreatitis.Methods: The level of SAA was determined by enzyme-linked immunosorbent assay(ELISA).The serum of 24 patients with different severity of AP from January 2017 to September 2018 was tested at 24 h,48 h and 72 h.The CRP level,APACHE II and Ranson score was recorded.ROC curve was performed to predict AP severity.Results: A total of 52 patients with AP were enrolled,including the mild,30;moderate-to-severe,13;the severe,9.The serum SAA levels in AP patients were significantly higher than that in control groups(P<0.01),and the serum SAA levels in three groups were also statistically significant(24h:234.01±98.86 vs.304.28±116.33 vs.573.48±121.11,P<0.05;48h:230.08±97.53 vs.310.59±111.16 vs.642.30±139.27,P<0.05;72h:102.61±47.75 vs.246.35±106.64 vs.730.10±159.22,P < 0.05,respectively).The serum SAA level in patients with different cause was not significantly different.The serum SAA levels of AP patients with different degrees of pancreatic necrosis were as statistically significant in the three groups(24h:232.86±98.37 vs.311.46±119.07 vs.589.65±124.52,P<0.05;48h:228.65±96.92 vs.315.89±113.06 vs.651.82±141.34,P<0.05;72h:109.23±50.83 vs.242.54±103.02 vs.725.34±158.18,P<0.05).And serum SAA was significantly higher in patients with organ dysfunction.In patients with organ dysfunction,the AUC of MAP+MSAP and SAP patients with a 24-hour SAA level was 0.761,the cut-off value was 370.76 ?g/L,the sensitivity was 77.8%,and the specificity was 76.7%.The AUC of 24 h SAA,48 h CRP,APACHE II and Ranson were 0.761,0.705,0.765 and 0.681,respectively.Conclusion: In early AP,the serum SAA levels were significantly elevated which were associated with organ dysfunction and pancreatic necrosis,but not with the cause.The serum SAA level of 24 hours after morbidity is higher than 370.76?g/L,suggesting that it is highly relating to the severe pancreatitis with highly diagnostic accuracy.