血清白介素-6检测联合序贯器官衰竭评估和多器官功能障碍评分预测高脂血症性急性胰腺炎严重程度及预后的临床价值

Clinical value of serum interleukin-6 detection combined with multiple organ dysfunction score and sequential organ failure assessment in predicting the severity and prognosis of hyperlipidemic acute pancreatitis

目的探究血清白介素-6(interleukin-6,IL-6)联合序贯器官衰竭评估(sequential organ failure assessment,SOFA)和多器官功能障碍评分(multiple organ dysfunction score,MODS)预测高脂血症性急性胰腺炎(hyperlipidemic acute pancreatitis,HLAP)严重程度及预后的临床价值。方法选择2017年1月至2018年6月中日友好医院收治入院的72例HLAP患者为研究对象,其中,轻症急性胰腺炎(mild acute pancreatitis,MAP)32例纳入MAP组,中重症急性胰腺炎(moderately severe acute pancreatitis,MSAP)18例纳入MSAP组,重症急性胰腺炎(severe acute pancreatitis,SAP)22例纳入SAP组。采用酶联免疫吸附测定检测三组患者血清IL-6水平,并于患者入院当日计算相应的MODS和SOFA评分。采用受试者操作特征曲线(receiver operator characteristic curve,ROC曲线)计算曲线下面积(area under the curve,AUC),分析血清IL-6检测联合MODS和SOFA评分预测HLAP严重程度及预后的临床价值。结果三组患者血清IL-6水平、MODS和SOFA评分比较差异均有统计学意义(均P<0.05),且其上述三项指标水平均为:MAP组<MSAP组<SAP组。72例HLAP患者中SAP 22例,发生器官功能衰竭13例,胰腺坏死9例,死亡4例。ROC曲线显示,血清IL-6检测联合MODS和SOFA评分预测HLAP严重程度、器官功能衰竭、胰腺坏死、死亡的AUC最大,其预测价值均优于单一指标。结论血清IL-6检测联合MODS和SOFA评分在预测HLAP严重程度及预后方面具有重要临床价值,其损伤方便,数据易收集,可帮助临床医生评估患者病情和预后。

Objective To investigate the clinical value of serum interleukin-6(IL-6)detection combined with sequential organ failure assessment score(SOFA score)and multiple organ dysfunction score(MODS score)in predicting the severity and prognosis of hyperlipidemic acute pancreatitis(HLAP).Method Seventy-two patients with HLAP who were admitted to China-Japan Friendship Hospital from January 2017 to June 2018 were selected,included 32 cases of mild acute pancreatitis(MAP),18 cases of moderately severe acute pancreatitis(MSAP),and 22 cases of severe acute pancreatitis(SAP).Serum IL-6 levels were measured by enzymelinked immunosorbent assay and the corresponding SOFA scores and MODS scores were calculated on the day of admission.The receiver operating characteristic(ROC)curve was used and the area under the curve(AUC)was calculated to analyze the value of serum IL-6 combined with MODS and SOFA score in predicting the severity and prognosis of HLAP.Result The difference in serum IL-6,MODS and SOFA score among the three groups were statistically significant(all P<0.05),and the levels of the above three indexes were:MAP group<MSAP group<SAP group.Among the 22 patients with SAP,there were 13 patients with organ failure,9 patients with pancreatic necrosis and 4 dead patients.ROC curve showed that the AUC of serum IL-6 combined with MODS and SOFA score were the largest for predicting the severity of HLAP,organ failure,pancreatic necrosis and death,and the prediction value were better than single index(all P<0.05).Conclusion The serum IL-6 detection combined with MODS and SOFA score is of great clinical value in predicting the severity and prognosis of HLAP.The operation is convenient and the data is easy to collect,which can help clinicians to predict the patient's condition and prognosis dynamically.