摘要
目的探讨急性胰腺炎患者血清CRP、IL-35和Presepsin水平变化及临床意义,以期为临床诊治提供理论依据。方法选取2017年1月1日-2018年12月31日某院诊治的167例急性胰腺炎患者作为研究组,根据其病情分为轻症急性胰腺炎102例和重症急性胰腺炎65例;同时选取同期50例健康体检人群作为对照组。收集研究对象基本资料,采集入组时血清检测CRP、IL-35和Presepsin水平,应用Pearson和Spearman相关性分析血清CRP、IL-35和Presepsin水平与Ranson评分、APACHE II评分及严重程度相关性,采用受试者工作特征曲线分析血清CRP、IL-35和Presepsin水平对急性胰腺炎患者病情严重程度的预测价值。结果研究组血清CRP和Presepsin水平为87.29(61.87,111.21)mg/l、765.09(564.02,1070.63)pg/ml,高于对照组5.23(3.14,7.83)mg/l、91.11(76.55,113.68)pg/ml,差异存在统计学意义,P<0.05;研究组血清IL-35水平为(59.29±17.21)ng/ml,低于对照组(117.76±46.52)ng/ml,差异存在统计学意义,P<0.05。SAP组血清CRP和Presepsin水平为104.75(84.56,128.61)mg/l、1083.12(954.82,1348.25)pg/ml,高于MAP组77.39(49.81,98.59)mg/l、606.92(459.48,806.47)pg/ml,差异存在统计学意义,P<0.05;SAP组血清IL-35水平为(47.80±9.71)ng/ml低于MAP组(66.61±16.97)ng/ml,差异存在统计学意义,P<0.05。血清CRP、Presepsin水平与Ranson评分和APACHEⅡ评分呈正相关,而IL-35与Ranson评分和APACHEⅡ评分呈负相关。血清CRP、IL-35和Presepsin诊断SAP患者的曲线下面积分别为0.750(0.676~0.824)、0.822(0.759~0.884)、0.868(0.806~0.929),临界值为83.38mg/L、59.93ng/m L和919.15pg/m L时,灵敏度分别为78.46%、87.69%、83.08%,特异度分别为58.82%、70.59%、85.29%。结论急性胰腺炎患者血清CRP和Presepsin水平上升,IL-35水平降低,与病情严重程度相关,可作为预测重症急性胰腺炎的生物标志物,但IL-35和Presepsin预测价值优于CRP。
Objective To investigate the changes and clinical significance of serum CRP, interleukin-35 and Presepsin in patients with acute pancreatitis. Methods From January 1, 2017 to December 31, 2018, 167 patients with acute pancreatitis were retrospectively analyzed as the research group. According to patient’s condition, they were divided into mild acute pancreatitis(102 cases) and severe acute pancreatitis(65 cases). Meanwhile, 50 healthy people were selected as the control group. The serum levels of CRP, IL-35 and Presepsin were detected. The correlation of serum CRP, IL-35, Presepsin with Ranson score, APACHE II score and severity were analyzed by Pearson and Spearman correlation analysis. The ROC curve were used to analyze the predictive value of serum CRP, IL-35 and Presepsin levels in patients with acute pancreatitis. Results The serum levels of CRP and Presepsin in the study group were 87.29(61.87, 111.21) mg/L and 765.09(564.02, 1070.63) pg/m L, respectively, which were significantly higher than those in the control group 5.23(3.14,7.83)mg/L, 91.11(76.55,113.68)pg/m L. The difference was statistically significant(P<0.05). The serum IL-35 level in the study group(59.29 ±17.21) ng/m L, was significantly lower than that in the control group(117.76 ±46.52) ng/m L. The difference was statistically significant(P<0.05). The serum CRP and Presepsin levels of 104.75(84.56, 128.61) mg/L and 1083.12(954.82, 1348.25) pg/m L, in SAP group were higher than those of 77.39(49.81, 98.59) mg/L and 606.92(459.48, 806.47) pg/m L in MAP group. The difference was statistically significant(P<0.05). The serum IL-35 level in SAP group(47.80±9.71)ng/m Lwas lower than that in MAP group(66.61±16.97)ng/m L. The difference was statistically significant(P<0.05). Serum CRP and Presepsin levels were positively correlated with Ranson score, APACHE Ⅱ score(P<0.05), while IL-35 were negatively correlated with Ranson score and APACHE Ⅱ score(P<0.05). The area under the curve of serum CRP, IL-35 and Presepsin were respectively 0.750(0.67
作者
张月凡
胡家骏
翟俊山
ZhangYuefan;Hu Jiajun;Zhai Junshan(Aerospace Center Hospital,Beijing 100049,China)
出处
《中国病案》
2021年第4期102-106,共5页
Chinese Medical Record
