细胞因子联合BISAP评分系统早期预测急性胰腺炎严重程度及预后的前瞻性研究

A prospective study of cytokines joint BISAP score in the early prediction of severity and prognosis for acute pancreatitis

目的分析细胞因子白介素6(IL-6)联合急性胰腺炎严重程度床边指数(BISAP)早期(病程<48 h)预测急性胰腺炎预后的临床价值。方法前瞻性选取2013年3月至2014年9月我院收治的确诊为急性胰腺炎(AP)的患者。所有患者入院时即抽取空腹静脉血测定IL-6,采用Ranson评分系统、BISAP评分以及IL-6联合BISAP评分判断胰腺炎患者预后,比较各评分系统的灵敏度以及特异度。结果共84例患者纳入本前瞻性研究,其中SAP 26例,MAP 58例。IL-6联合BISAP评分预测急性胰腺炎患者器官功能衰竭、胰腺坏死优于Ranson评分(P<0.05)及BISAP评分;三种评分系统对于预测患者死亡方面无显著差异(P>0.05)。结论细胞因子IL-6联合BISAP评分系统对早期预测急性胰腺炎严重程度及预后更有价值。

Objective To analyze the cytokine interleukin 6 （IL-6） combined with bedside index for severity in acute pancreatitis （BISAP） at early time （〈48 h） to predict the clinical value of prognosis for acute pancreatitis. Methods Patients diagnosed with acute pancreatitis （AP） in our hospital from March 2013 to September 2014 were selected prospectively. All patients had fasting vein blood drawing for IL-6 when hos-pitalized. Ranson criteria, BISAP score,and IL-6 combined with BISAP score were used for judging the prog-nosis of patients with acute pancreatitis. The sensitivity and specificity among the different scoring system were compared. Results There were 84 cases in this prospective study in total, including 26 cases of SAP and 58 cases of MAP. IL-6 combined with BISAP score was superior to Ranson score and BISAP score for predicting the organ failure and pancreatic necrosis in patients with acute pancreatitis （P〈0.05）;There was no significant difference among the three scoring system for predicting death of patients （P〉0.05）. Conclusion Cytokines IL-6 combined with BISAP score system was more valuable in early prediction of severity and prognosis for acute pancreatitis.