摘要
目的分析白细胞介素-6(Interleukin-6,IL-6)、肝素结合蛋白(Heparin binding protein,HBP)、降钙素原(Procalcitonin,PCT)预测急性胰腺炎(Acute pancreatitis,AP)合并腹腔感染的价值,为感染性疾病的早期诊断和治疗提供依据。方法连续选取2018年3月-2019年12月的535例AP患者作为研究对象,对其腹腔感染情况进行观察,并将患者分为感染组和未感染组。分析比较两组患者的临床特征及入院当日的血清IL-6、HBP、PCT水平。结果有191例AP患者发生腹腔感染,感染率为35.7%。感染组患者的年龄及合并糖尿病、低氧血症、多器官功能损害的比例高于未感染组,差异均有统计学意义(P<0.05)。感染组患者入院当日的血清IL-6、HBP、PCT水平均高于未感染组,差异均有统计学意义(P<0.05)。受试者工作特征(Receiver operating characteristic,ROC)曲线分析结果显示,血清IL-6、HBP、PCT水平预测AP合并腹腔感染的ROC曲线下面积(Area under ROC curve,AUC^(ROC))均具有统计学意义(P<0.05),分别为0.777、0.739、0.765,在Cutoff值下,灵敏度分别为0.424、0.397、0.408,特异度分别为0.753、0.802、0.788,三种血清指标联合检验时,灵敏度和特异度分别为0.796和0.741。结论合并腹腔感染的AP患者在入院早期可出现血清IL-6、HBP、PCT水平的升高,这三个指标在预测感染方面均具有一定价值,将其进行联合检测可提高预测的灵敏度。
OBJECTIVE To study and analyze the values of interleukin-6(IL-6),heparin binding protein(HBP)and procalcitonin(PCT)in predicting acute pancreatitis(AP)complicated with abdominal infection,so as to provide basis for early diagnosis and treatment of infectious diseases.METHODS A total of 535 AP patients in our hospital from Mar 2018 to Dec 2019 were recruited as the research subjects.The occurrence of abdominal infection in the patients were observed,according to which patients were divided into the infection group and the non-infection group.The clinical characteristics and the levels of serum IL-6,HBP and PCT on the day of admission between the two groups were analyzed and compared.RESULTS There were 191 cases of abdominal infection,and the infection rate was 35.7%.The age,the proportions of diabetes mellitus,hypoxemia and multiple organ dysfunction in the infection group were significantly higher than those in the non-infection group.The levels of serum IL-6,HBP and PCT on the day of admission in the infection group were significantly higher than those in the non-infection group.Receiver operating characteristic curve(ROC)analysis showed that the area under ROC curves(AUC^(ROC))of serum IL-6,HBP and PCT levels in predicting AP complicated with abdominal infection were significant(P<0.05),which were 0.777,0.739 and 0.765,respectively;the sensitivity of single detection was 0.424,0.397 and 0.408,and the specificity was 0.753,0.802 and 0.788,respectively.When the three serum indicators were combined,the sensitivity and specificity were 0.796 and 0.741,respectively.CONCLUSION The serum levels of IL-6,HBP and PCT can be increased in AP patients with abdominal infection in the early stage of admission.These three indicators have certain values in predicting infections,and their combined detection can improve the sensitivity of prediction.
作者
付明月
窦炜
李万瑀
李绥邦
孙海珍
FU Ming-yue;DOU Wei;LI Wan-yu;LI Sui-bang;SUN Hai-zhen(Qinghai Red Cross Hospital,Xining,Qinghai 810000,China;不详)
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2021年第15期2327-2331,共5页
Chinese Journal of Nosocomiology
基金
青海省自然科学基金青年项目(2017-ZJ-983Q)。
