Abstract:Objective To investigate the predictive value of biochemical indicators of intestinal barrier function，such as diamine oxidase，D-lactate and bacterial endotoxin for the severity of acute pancreatitis. Methods A total of 139 patients with acute pancreatitis admitted to Nanjing Jiangbei Hospital from December 2021 to January 2023 were retrospectively enrolled. The patients were divided into mild group（mild acute pancreatitis，n=39）and non-mild group（moderately severe acute pancreatitis and severe acute pancreatitis，n=100）. The serum levels of diamine oxidase，D-lactate，and bacterial endotoxin，as well as Acute Physiology and Chronic Health Evaluation Ⅱ（APACHE Ⅱ）score，Bedside Index of Severity in Acute Pancreatitis（BISAP）score and Modified Computed Tomography Severity Index（MCTSI）score were collected and compared between the two groups. Spearman correlation analysis was used to analyze the correlation among the above indicators，and receiver operating characteristic（ROC）curve was adopted to evaluate the predictive value of each indicator for non-mild acute pancreatitis. Results Compared with mild group，the levels of diamine oxidase，D-lactate，bacterial endotoxin，APACHE Ⅱscore，BISAP score and MCTSI score in the non-mild group were significantly higher，while the blood calcium level was lower（P<0.05）. In both groups，spearman correlation analysis showed that the levels of diamine oxidase，D - lactate and bacterial endotoxin were positively correlated with APACHE Ⅱ，BISAP and MCTSI scores，respectively（P<0.05）. ROC curve analysis revealed that the area under the curve（AUC）of diamine oxidase，D - lactate and bacterial endotoxin for predicting non - mild acute pancreatitis was 0.690，0.749 and 0.718，respectively，and the combination of D-lactate and the BISAP score presented the largest AUC of 0.852. Conclusion Biochemical indicators of intestinal barrier function have certain predictive value for evaluating the severity of acute pancreatitis，and their combination with scoring systems can achieve higher predictive efficacy.