C反应蛋白、降钙素原和白细胞介素6在早期急性胰腺炎合并感染中的诊断价值分析

Diagnostic Value Analysis of C-Reactive Protein,Procalcitonin,and Interleukin-6 in Early Acute Pancreatitis Complicated with Infection

目的探讨C反应蛋白(CRP)、降钙素原(PCT)、白细胞介素6(IL-6)在早期急性胰腺炎(AP)合并感染中的诊断价值。方法选择2022年1月至2024年1月滕州市中心人民医院消化内科收治的112例AP患者,依据患者入院时的严重程度将其划分为3组分别为轻症组、中重症组、重症组。记录入院首日、3 d、7 d,IL-6、CRP、PCT水平;同时以Spearman相关性分析病情严重程度与IL-6、CRP、PCT相关性。结果入院首日,3组患者IL-6、CRP、PCT水平均高于各指标正常参考范围。IL-6水平入院首日、入院3 d、入院7 d,重症组>中重症组>轻症组(P<0.05),且入院7 d>入院3 d>入院首日(P<0.05)。CRP水平,重症组、中重症组入院首日无差异(P>0.05),重症组、中重症组>轻症组(P<0.05);入院3 d、入院7 d,重症组>中重症组>轻症组(P<0.05),且入院7 d>入院3 d>入院首日(P<0.05)。入院不同时间三组PCT水平,均重症组>中重症组>轻症组(P<0.05);轻症组、中重症组入院不同时间段PCT水平,均入院3 d>入院7 d>入院首日(P<0.05);重症组入院3 d、入院7 d比较无差异(P>0.05),入院3 d、入院7 d>入院首日(P<0.05)。IL-6、CRP、PCT、IL-6+CRP+PCT对AP的AUC分别为0.82、0.85、0.90、0.94。IL-6、CRP、PCT预测AP的截断值分别为50.77 ng/L、124.56 mg/L、3.25μg/L。经ROC曲线分析显示,PCT为最佳AP预测因子,IL-6、CRP、PCT联合诊断准确性更高。结论PCT、CRP、IL-6单一或联合用于AP合并感染的诊断评估均具有一定价值,且三者联合应用诊断价值更高,可早期评价患者病情严重程度,指导疾病治疗,建议将其作为AP早期病情评估、预后预测参考指标。

Objective To explore the diagnostic value of C-reactive protein(CRP),procalcitonin(PCT),and interleukin-6(IL-6)in early acute pancreatitis(AP)complicated with infection.Methods One hundred and twelve AP patients admitted to the Gastroenterology Department of Tengzhou Central People's Hospital from January 2022 to January 2024 were selected and divided into three groups based on their severity at admission,mild group,moderate severe group,and severe group.Record the levels of IL-6,CRP,and PCT on the first day of admission,3 days,and 7 days;At the same time,Spearman correlation analysis was used to determine the correlation between the severity of the disease and IL-6,CRP,and PCT.Results On the first day of admission,the levels of IL-6,CRP and PCT in 3 groups were higher than the normal reference range of each index.The levels of IL-6 on the first day of admission,3 days after admission,and 7 days after admission,the severe group>moderate severe group>mild group(P<0.05),and 7 days>3 days>the first day of admission(P<0.05).There was no difference in CRP level on the first day of admission between the severe group and the middle severe group(P>0.05),and the severe group and the middle severe group>the mild group(P<0.05).3 days after admission,7 days after admission,severe group>moderate severe group>mild group(P<0.05),and 7 days>3 days>the first day of admission(P<0.05);At different times of admission,the levels of PCT in three groups were significantly higher in the severe group than in the moderate severe group and the mild group(P<0.05);The PCT levels in the mild and moderate to severe groups at different time periods of admission were 3 days after admission>7 days after admission>the first day of admission(P<0.05);There was no significant difference(P>0.05)between the three days and seven days of admission in the critically ill group,while the three days and seven days of admission were higher than the first day of admission(P<0.05).The AUC of IL-6,CRP,PCT and IL-6+CRP+PCT for AP were 0.82,0.85,0.90 and 0.94,respectively.The cut-off values of IL-6,CRP and PCT for AP were 50.77 ng/L,124.56 mg/L and 3.25μg/L,respectively.ROC curve analysis showed that PCT was the best predictor of AP,and the combined diagnosis accuracy of IL-6,CRP and PCT was higher.Conclusions The single or combined use of PCT,CRP,and IL-6 for the diagnosis and evaluation of AP combined infection has certain value,and the combined use of the three has higher diagnostic value.It can early evaluate the severity of the patient's condition,guide disease treatment,and is recommended to use them as reference indicators for early AP condition evaluation and prognosis prediction.