Abstract: Objective This study aimed to elucidate the correlation between serum levels of circ_UTRN and circ_ZFP644 and disease severity in patients with acute pancreatitis （AP）. Methods A cohort of 188 AP patients admitted between October 2020 and August 2025 was enrolled as the AP group, while 90 healthy individuals undergoing routine physical examinations served as the control group. Serum expression levels of circ_UTRN and circ_ZFP644 were quantified using quantitative real-time polymerase chain reaction. Based on clinical severity criteria, AP patients were stratified into mild, moderately severe, and severe subgroups for comparative analysis, and into good prognosis group and poor prognosis group according to the prognosis. The correlations between the expression levels of serum circ_UTRN and circ_ZFP644 in AP patients and the bedside index for severity in acute pancreatitis （BISAP） score and the acute physiology and chronic health evaluation Ⅱ （APACHE Ⅱ） score, the independent factors influencing the prognosis of AP patients, the predictive capacity of serum circ_UTRN and circ_ZFP644 expression levels for prognosis were analyzed. Results The expression levels of serum circ_UTRN and circ_ZFP644 in the AP group were lower than those in the control group, with statistically significant differences （P<0.05）. The expression levels of circ_UTRN and circ_ZFP644 in the serum of the AP group were as follows： mild group > moderately severe group > severe group（P<0.05）. The expression levels of serum circ_UTRN and circ_ZFP644 in AP patients were negatively correlated with the BISAP score and the APACHE II score （P<0.05）. The expression levels of serum circ_UTRN and circ_ZFP644 in AP patients with poor prognosis were lower than those in patients with good prognosis, while the BISAP score, APACHE II score, C-reactive protein level, and procalcitonin level were higher than those in patients with good prognosis, with statistically significant differences （P<0.05）. Serum circ_UTRN and circ_ZFP644 were protective factors for a poor prognosis in AP, while the BISAP score and APACHE II score were risk factors for a poor prognosis in AP （P<0.05）. The area under the curve for the combined prediction of AP prognosis by serum circ_UTRN and circ_ZFP644 was higher than that of either indicator alone（P<0.05）. Conclusion The low expression levels of serum circ_UTRN and circ_ZFP644 are significantly associated with disease progression and poor prognosis in AP patients, the combined detection has predictive value for the prognosis of AP.

Key words: acute pancreatitis, circ_UTRN, circ_ZFP644, prognosis