急性胰腺炎患者血清MCP-1、IL-6水平变化及临床意义

The levels of serum MCP-1 and IL-6 in patients with acute pancreatitis and its clinical significance

目的探讨急性胰腺炎(AP)患者血清单核细胞趋化因子蛋白1(MCP-1)和白细胞介素-6(IL-6)的动态变化及临床意义。方法收集2016年6月至2017年12月该院收治的103例AP患者为研究对象,根据病情将其分为轻症急性胰腺炎(MAP组,n=62)和重症急性胰腺炎(SAP组,n=41),采用放射免疫法测定两组患者入院第1、3、7天血清MCP-1、IL-6水平,并与同期随机选取的40例健康体检者(对照组)比较,并分析血清MCP-1、IL-6对AP预后的预测价值。结果 MAP组、SAP组入院第1天血清MCP-1、IL-6水平及APACHEⅡ评分均高于对照组,且MAP组、SAP组患者入院第3、7天高于第1天,入院第7天低于入院第3天,差异均有统计学意义(P<0.05);SAP组患者入院第1、3、7天血清MCP-1、IL-6水平及APACHEⅡ评分均高于MAP组,差异有统计学意义(P<0.05)。AP患者血清MCP-1、IL-6与APACHEⅡ评分呈不同程度正相关(P<0.05)。入院第3天,血清MCP-1鉴别诊断AP的最佳临界值为31.6pg/mL,ROC曲线下面积0.852,灵敏度、特异度分别为0.87、0.82,准确性为0.85;血清IL-6鉴别诊断AP的最佳临界值为35.9ng/L,ROC曲线下面积0.876,灵敏度、特异度分别为0.91、0.85,准确性为0.87。结论 AP患者血清MCP-1、IL-6异常改变,并与病情严重程度及预后密切相关,早期联合检测有助于判断AP患者病情及评估预后。

Objective To explore the dynamic changes of serum monocyte chemoattractant protein-1(MCP-1)and interleukin-6(IL-6)in patients with acute pancreatitis(AP)and its clinical significance.Methods A total of 103 patients with AP admitted to our hospital from June 2016 to December 2017 were selected,which were divided into mild AP(MAP group,n=62)and severe AP(SAP group,n=41)according to the condition of disease.The levels of serum MCP-1 and IL-6 at 1st,3rd,7th day after admission were determined by the radioimmunoassay.At the same time,a total of 40 healthy volunteers as control group were randomly selected.The predictive value of serum MCP-1 and IL-6 on for AP was analyzed.Results The serum MCP-1,IL-6 level and APACHEⅡscore of MAP group and SAP group at 1st day were higher than those of control group(P﹤0.05).The serum MCP-1,IL-6 level and APACHEⅡscore of MAP group and SAP group at 3rd,7th day were higher than those at 1st,and which at 7th were lower than those at 3rd(P﹤0.05).The serum MCP-1,IL-6 level and APACHEⅡscore of SAP group at 1st,3rd,7th were higher than those of MAP group(P﹤0.05).Among patients with AP,serum MCP-1 and IL-6 were positively associated with APACHEⅡscore(P﹤0.05).The best cutoff value of serum MCP-1 for AP was 31.6 pg/mL,and the area under ROC curve was 0.852,and the sensitivity and specificity was 0.87 and 0.82 respectively,and the accuracy was 0.85.The best cutoff value of serum IL-6 for AP was 35.9 ng/L,and the area under ROC curve was 0.876,and the sensitivity and specificity were 0.91 and 0.85 respectively,and the accuracy was 0.87.Conclusion The serum MCP-1 and IL-6 of patients with AP abnormal changes,which were closely related to the severity and prognosis.Early detection of MCP-1 and IL-6 can help to judge condition and evaluate prognosis.