Objective  To investigate the expression and clinical significance of peripheral blood glucose regulatory protein 78 (GRP78) and miR-181-5p in patients with acute pancreatitis (AP).

  Methods  A total of 141 AP patients were selected as research objects. According to the severity of AP, they were divided into mild group (86 cases) and severe group (55 cases). A total of 100 healthy people who underwent physical examinations in our hospital during the same period were selected as control group. Real-time fluorescent quantitative PCR method was used to detect the expression levels of serum miR-181-5p and GRP78 mRNA in subjects. Pearson method was used to analyze the correlation between serum miR-181-5p and GRP78 mRNA expression level. Receiver operating characteristic (ROC) curve was used to analyze the predictive value of serum miR-181-5p and GRP78 mRNA expression levels for severe AP.

  Results  The expression levels of serum miR-181-5p in the control group, the mild group, and the severe group increased sequentially, and their expression levels of GRP78 mRNA decreased (P < 0.05). The expression level of miR-181-5p was negatively correlated with GRP78 mRNA (r=-0.665, P < 0.05). Higher level of miR-181-5p and lower level of GRP78 mRNA were risk factors affecting severe AP (P < 0.05). ROC curve showed that the area under the curve (AUC) was 0.836 predicting severe AP by serum miR-181-5p, was 0.741 by serum GRP78 mRNA, and was 0.861 by combined detection.

  Conclusion  The miR-181-5p expression level in serum increases and the GRP78 mRNA expression level decreases in AP patients, they are both related to the severity of AP. They have a certain predictive value for severe AP and may be used as potential predictive markers.