血清CRP、PCT、LPS及IL-6对重症急性胰腺炎发生感染性胰腺坏死的预测价值分析

Predictive value of serum CRP,PCT,LPS and IL-6 in the diagnosis of infectious pancreatic necrosis in severe acute pancreatitis

目的:探讨血清C-反应蛋白(CRP)、降钙素原(PCT)、血脂肪酶(LPS)及白细胞介素-6(IL-6)检测对重症急性胰腺炎(severe acute pancreatitis,SAP)继发感染性胰腺坏死的预测价值。方法:收集120例SAP患者临床资料,根据是否继发感染性胰腺坏死分为感染组(n=48)和未感染组(n=72)。比较两组患者血清CRP、PCT、LPS及IL-6等生化指标,采用受试者工作特征(ROC)曲线分析相关指标的临床预测价值。结果:两组WBC计数、LMS、Hg指标比较,差异无统计学意义(P>0. 05),感染组血清CRP、PCT、LPS及IL-6指标均显著高于未感染组(P <0. 05); ROC曲线分析显示,血清CRP、PCT、LPS、IL-6对SAP继发感染性胰腺坏死的预测效能满意,AUC分别为:0. 768、0. 812、0. 736、0. 695,Cut-off依次为:234. 27 mg/L、7. 73 ng/L、607. 89 U/L、96. 8μmol/L。结论:继发感染性胰腺坏死的SAP患者血清CRP、PCT、LPS、IL-6指标呈明显异常偏高,早期应加强SAP患者上述指标检测,对预测后期发生感染性胰腺坏死具有显著价值。

Objective:To investigate the predictive value of serum C-reactive protein(CRP),procalcitonin(PCT),lipase(LPS)and interleukin-6(IL-6)levels in patients with severe acute pancreatitis(SAP)secondary infectious pancreatic necrosis.Methods:120 patients with SAP were divided into infection group(n=48)and non-infection group(n=72)according to whether secondary infectious pancreatic necrosis occurred.The expression characteristics of serum CRP,PCT,LPS and IL-6 were compared.The clinical predictive value of these indexes was analyzed by the Receiver Operating Characteristic(ROC)curve.Results:There was no significant difference in WBC count,LMS and HG expression between the two groups(P>0.05).The expressions of CRP,PCT,LPS and IL-6 in serum of the infected group were significantly higher than those of the uninfected group(P<0.05).ROC curve analysis showed that CRP,PCT,LPS and IL-6 in serum were satisfactory in predicting SAP secondary infective pancreatic necrosis,AUC were 0.768,0.812,0.736 and 0.695,respectively.Cut-off was 234.27 mg/L,7.73 ng/L,607.89U/L and 96.8 micromol/L,respectively.Conclusion:The expression of CRP,PCT,LPS and IL-6 in serum of SAP patients with secondary infectious pancreatic necrosis is obviously abnormally high.It is necessary to strengthen the detection of these indexes in early stage of SAP patients,which has significant value in predicting the occurrence of infectious pancreatic necrosis in later stage.