| 李 静,孟文勤,张江英,乌雅罕,李彩霞.炎症因子表达水平与重症急性胰腺炎预后及肠道屏障损伤的相关性[J].现代生物医学进展英文版,2023,(9):1726-1730. |
| 炎症因子表达水平与重症急性胰腺炎预后及肠道屏障损伤的相关性 |
| Correlation between the Expression of Inflammatory Factors and Prognosis of Severe Acute Pancreatitis and Intestinal Barrier Injury |
| Received:September 27, 2022 Revised:October 22, 2022 |
| DOI：10.13241/j.cnki.pmb.2023.09.025 |
| 中文关键词: 炎症因子 SAP 肠道屏障损伤 灵敏度 特异度 |
| 英文关键词: Inflammatory factors SAP Intestinal barrier damage Sensitivity Specificity |
| 基金项目:内蒙古自治区自然科学基金面上项目（2019MS08081） |
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| 中文摘要: |
| 摘要 目的：探讨白细胞介素-6（IL-6）、降钙素原（PCT）、C反应蛋白（CRP）相关炎症因子表达水平对重症急性胰腺炎（SAP）预后的预测价值，并分析不同炎症因子表达与肠道屏障损伤的相关性。方法：选取我院2019年8月到2022年8月收治的60例SAP患者为研究对象，对所有患者进行28 d随访，将28 d内死亡的20例患者分为死亡组，将其余40例患者分为存活组，对比两组患者临床一般情况与IL-6、PCT、CRP相关炎症因子表达水平，并分析SAP预后影响的独立危险因素。随后将所有患者依照肠道屏障损伤情况进行分组，分为肠道屏障损伤组（n=42）与非肠道损伤组（n=18），对比两组患者IL-6、PCT、CRP表达水平，分析炎症因子表达水平与肠道屏障损伤的相关性，并绘制各指标诊断SAP肠道屏障损伤的ROC曲线，分析其预测肠道屏障损伤的灵敏度与特异度。结果：存活组与死亡组患者胰腺坏死、APACHEⅡ评分、发生器官衰竭情况与IL-6、PCT、CRP表达水平对比差异显著（P＜0.05）；PCT、CRP、APACHEⅡ评分为重症胰腺炎患者的预后不良影响因素（P＜0.05）；肠道屏障损伤组患者IL-6、PCT、CRP表达水平明显高于非肠道屏障损伤组（P＜0.05）；Spearman相关分析结果显示：IL-6、PCT、CRP与肠道屏障损伤呈正相关（P＜0.05）；ROC曲线分析显示：曲线下面积（AUC）从低到高依次为IL-6 (0.631)、CRP（0.667）、PCT（0.671）、联合诊断（0.852）。血清IL-6、PCT、CRP的联合诊断的灵敏度与特异度明显高于血清IL-6、PCT、CRP单一诊断（P＜0.05）。结论：IL-6、PCT、CRP相关炎症因子表达水平可预测SAP患者预后情况，IL-6、PCT、CRP与SAP肠道屏障损伤呈正相关，且三者联合对SAP肠道屏障损伤的诊断具有重要价值。 |
| 英文摘要: |
| ABSTRACT Objective: To explore the predictive value of the expression levels of interleukin-6 (IL-6), procalcitonin (PCT), C-reactive protein (CRP) - related inflammatory factors on the prognosis of severe acute pancreatitis (SAP), and to analyze the correlation between the expression of different inflammatory factors and intestinal barrier damage. Methods: 60 SAP patients admitted to our hospital from August 2019 to August 2022 were selected as the research objects. All patients were followed up for 28 days. 20 patients who died within 28 days were divided into death groups, and the remaining 40 patients were divided into survival groups. The clinical general conditions and the expression levels of IL-6, PCT and CRP related inflammatory factors of the two groups were compared, and the independent risk factors affecting the prognosis of SAP were analyzed. Subsequently, all patients were divided into intestinal barrier injury group (n=23) and non intestinal barrier injury group (n=37) according to the intestinal barrier injury. The expression levels of IL-6, PCT and CRP in the two groups were compared. Spearman correlation analysis was used to analyze the correlation between the expression level of inflammatory factors and intestinal barrier injury, and the ROC curve of each index in diagnosing SAP intestinal barrier injury was drawn, To analyze the sensitivity and specificity of predicting intestinal barrier injury. Results: There was difference in pancreatic necrosis, sapache Ⅱ score, occurrence of organ failure and expression levels of IL-6, PCT and CRP between the survival group and the death group (P<0.05); PCT, CRP and sapache Ⅱ scores were the poor prognostic factors in patients with severe pancreatitis (P<0.05); The expression levels of IL-6, PCT and CRP in the intestinal barrier injury group were higher than those in the non intestinal barrier injury group (P<0.05); Spearman correlation analysis showed that IL-6, PCT and CRP were positively correlated with intestinal barrier injury (P<0.05); ROC curve analysis showed that the area under the curve (AUC) from low to high was IL-6 (0.631), CRP (0.667), PCT (0.671) and combined diagnosis (0.852). The sensitivity and specificity of combined diagnosis of serum IL-6, PCT and CRP were higher than those of single diagnosis of serum IL-6, PCT and CRP (P<0.05). Conclusion: The expression levels of IL-6, PCT and CRP related inflammatory factors can predict the prognosis of SAP patients. IL-6, PCT and CRP are positively correlated with SAP intestinal barrier damage, and the combination of the three has important value in the diagnosis of SAP intestinal barrier damage. |
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