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目的:探讨血清肠型脂肪酸结合蛋白(I-FABP)、肝素结合蛋白(HBP)、白细胞介素-1β(IL-1β)动态监测对急性重症胰腺炎(SAP)并发腹腔间隔室综合征(ACS)的早期预测及病情评估价值。方法:回顾性分析2019年7月至2021年1月安徽医科大学第二附属医院急诊外科诊治的65例SAP患者的临床资料，根据是否并发ACS将其分为无ACS组(48例)、ACS组(17例)，动态监测两组患者血清I-FABP、HBP、IL-1β水平，通过相关性分析以及受试者工作特征(ROC)曲线分别评判各观察指标对SAP患者并发ACS病情严重程度的评估效能及早期预测价值。结果:两组患者年龄、性别、体重指数(BMI)、病因差异均无统计学意义(均n P>0.05)，ACS组CRP水平、WBC水平、入院时急性生理与慢性健康评分Ⅱ(APACHE Ⅱ)以及腹内压(IAP)最大值均高于无ACS组(均n P<0.05)；ACS组第1、4、7天I-FABP[(97.41±15.02)ng/ml vs (37.28±18.34)ng/ml、(103.32±18.40)ng/ml vs (56.96±19.12)ng/ml、(85.69±22.94)μg/L vs (36.88±10.49)ng/ml]、HBP[(92.19±14.59)ng/ml vs (24.56±10.96)ng/ml、(106.11±15.03)ng/ml vs (37.17±13.83)ng/ml、(128.11±16.43)ng/ml vs (68.94±15.91)ng/ml]、IL-1β水平[(15.78±1.44)pg/ml vs (11.26±1.34)pg/ml、(19.34±1.87)pg/ml vs (13.51±2.84)pg/ml、(20.95±1.96)pg/ml vs (16.03±1.04)pg/ml]均持续显著高于无ACS组(均n P<0.01)；相关性分析提示，I-FABP、HBP、IL-1β三项指标与IAP最大值(n r＝0.745，0.793，0.770)和入院时APACHE Ⅱ评分(n r＝0.510，0.489，0.445)均呈正相关(均n P0.05). The serum levels of C-reactive protein (CRP), white blood cell (WBC), Acute Physiology and Chronic Health Enquiry (APACHE-Ⅱ) score and intra-abdominal pressure (IAP) in ACS group were significantly higher than those in non ACS group (alln P<0.05). The serum levels of I-FABP [(97.41±15.02)ng/ml vs (37.28±18.34)ng/ml, (103.32±18.40)ng/ml vs (56.96±19.12)ng/ml, (85.69±22.94)ng/ml vs (36.88±10.49)ng/ml], HBP [(92.19±14.59)ng/ml vs (24.56±10.96)ng/ml, (106.11±15.03)ng/ml vs (37.17±13.83)ng/ml, (128.11±16.43)ng/ml vs (68.94±15.91)ng/ml] and IL-1β[(15.78±1.44)pg/ml vs (11.26±1.34)pg/ml, (19.34±1.87)pg/ml vs (13.51±2.84)pg/ml, (20.95±1.96)pg/ml vs (16.03±1.04)pg/ml] on 1st, 4th, 7th day in ACS group were continuously and evidently higher than those in non ACS group (n P<0.01). Correlation analysis revealed that I-FABP, HBP and IL-1β were positively correlated with IAP (n r=0.745, 0.793, 0.770) and APACHE Ⅱ score (n r=0.510, 0.489, 0.445) (all n P<0.01). ROC curve analysis showed that the AUC of early prediction by I-FABP, HBP and IL-1β on the occurrence of ACS were 0.846, 0.873 and 0.902 respectively, which were higher than the CRP (0.681), WBC (0.765) and APACHE Ⅱ score (0.795), the sensitivity and specificity can be significantly improved to 0.997 and 0.994 by parallel and series tests respectively combined with the three indicators.n Conclusions:Dynamic detection of serum I-FABP, HBP and IL-1β has a certain clinical value in evaluating the severity of ACS in SAP patients. At the same time, early detection with serum I-FABP, HBP and IL-1β has high predictive power for ACS in SAP patients and the combined application of three has higher predictive value.