中国全科医学2017，Vol.20Issue(25)：3127-3131,5.DOI:10.3969/j.issn.1007-9572.2017.25.013
不同炎性因子对重症急性胰腺炎的预测价值研究
Predictive Value of Inflammatory Cytokines in Severe Acute Pancreatitis
摘要
Abstract
Objective To investigate the predictive value of inflammatory cytokines in severe acute pancreatitis (SAP).Methods A prospective observational study was conducted in Lanzhou University Second Hospital.The participants were 40 cases of acute pancreatitis (AP) with organ dysfunction admitted in the Surgical Intensive Care Unit (SICU) of the hospital from June 2014 to October 2016.Of them,27 cases with organ dysfunction within 48 h after SICU admission were assigned to the moderate to severe acute pancreatitis (MSAP) group,and other 13 cases with organ dysfunction more than 48 h after SICU admission were assigned to the severe acute pancreatitis (SAP) group.We compared the concentrations of tumor necrosis factor-alpha (TNF-α),interleukin 1 (IL-1),interleukin 6 (IL-6),interleukin 8 (IL-8) and interleukin 10 (IL-10) measured on SICU admission between the groups.We selected the inflammatory cytokines associated with SAP from the above inflammatory cytokines by using analyses with Spearman's rank correlation and Logistic regression models and compared the predictive value of them in SAP based on analyzing their ROC curves and cut-off values for the prediction of SAP.Results The levels of TNF-α and IL-6 measured on SICU admission differed significantly between the groups (P ＜0.05),while those of IL-1,IL-8 and IL-10 did not (P ＞ 0.05).Analysis with Spearman's rank correlation found that,levels of TNF-o had a positive corrclation with SAP (rs =0.539,P ＜ 0.05);levels of IL-6 were positively correlated with SAP (rs =0.557,P ＜ 0.05);but no correlation was found between SAP and levels of IL-1,IL-8 and IL-10 (rs =0.303,P ＞0.05;rs =0.284,P ＞0.05;rs =-0.257,P ＞ 0.05,respectively).The analysis with Logistic regression models demonstrated that,levels of TNF-α and IL-6 were found to have predictive value for SAP [OR =1.143,95％ CI (1.011,1.293),P ＜0.05;OR =1.084,95％CI (1.014,1.158),P ＜ 0.05,respectively].Both TNF-α and IL-6 had good performance in the prediction of SAP provedby the area under the ROC curve (AUC) [0.832 (0.700,0.964),P＜0.05;0.843 (0.684,1.000),P ＜0.05,respectively].For predicting SAP,the optimal cut-off value of TNF-α and IL 6 was 141.7 pg/L,143.3 pg/L,respectively with maximized sensitivity and specificity.Conclusion The levels of plasma TNF-α and IL-6 measured early in ICU patients with AP have values in the prediction of SAP,while those of other inflammatou cytokines do rot,which provides a theoretical basis for taking measures to protect the patients' organ function as soon as possible.关键词
重症急性胰腺炎/炎性因子/肿瘤坏死因子α/白细胞介素6/预测Key words
Severe acute pancreatitis/Inflammatory cytokines/Tumor necrosis factor-α/Interleukin-6/Forecasting分类
医药卫生引用本文复制引用
张红松,冯芳,付丽彬,齐艳,蔡红燕..不同炎性因子对重症急性胰腺炎的预测价值研究[J].中国全科医学,2017,20(25):3127-3131,5.基金项目
甘肃省兰州市城关区科技计划项目(2015-3-7) （2015-3-7）
