血清IL-6联合Wnt5a及syndecan-1对急性胰腺炎患者合并急性呼吸窘迫综合征的预测价值

Prognostic value of serum IL-6 combined with Wnt5a and syndecan-1 on ARDS in patients with acute pancreatitis

目的:探讨血清白细胞介素(IL)-6、Wnt5a及syndecan-1检测对急性胰腺炎(AP)患者发生急性呼吸窘迫综合征(ARDS)的预测价值。方法:选择2017年8月—2020年7月天津医科大学第二医院重症医学科收治的75例AP患者,根据是否发生ARDS分为ARDS组(30例)及非ARDS组(45例)。比较两组患者的一般临床资料、血白细胞计数、肝酶、血乳酸、胆红素、血淀粉酶及脂肪酶等指标,采用受试者工作特征(ROC)曲线下面积(AUC)评估IL-6、Wnt5a、syndecan-1单独及联合检测对AP发生ARDS的预测价值。结果:ARDS组血清IL-6、Wnt5a及syndecan-1数值均明显高于非ARDS组(Z=-6.046、-3.662,t=2.142,均P<0.01)。ROC曲线显示,血清IL-6、Wnt5a、syndecan-1及三者联合检测预测AP患者合并ARDS的曲线下面积分别为:0.899(95%CI:0.809~0.989,P<0.01)、0.826(95%CI:0.726~0.926,P<0.01)、0.849(95%CI:0.765~0.933,P<0.01)、0.956(95%CI:0.915~0.997,P<0.01),敏感性分别为86.7%、73.3%、86.7%、90.0%,特异性分别为95.6%、86.7%、68.9%、93.3%。结论:血清IL-6、Wnt5a、syndecan-1联合检测对AP患者发生ARDS的预测有较高临床应用价值。

Objective:To investigate the predictive value of serum IL-6,Wnt5a and syndecan-1 in the occurrence of acute respiratory distress syndrome(ARDS)in patients with acute pancreatitis(AP).Methods:From August 2017 to July 2020,75 patients with acute pancreatitis were selected in the Department of Critical Medicine,the Second Hospital of Tianjin Medical University.According to whether ARDS occurred,they were divided into ARDS group(n=30)and non-ARDS group(n=45).The general clinical data,blood white blood cell count,liver enzyme,blood lactic acid,bilirubin,serum amylase and lipase and other indicators were compared between the two groups.The area under the curve(AUC)of receiver operating characteristic(ROC)was used to evaluate the predictive value of IL-6,Wnt5a and syndecan-1 alone and in combination for the occurrence of ARDS in acute pancreatitis.Results:The serum IL-6,Wnt5a,syndecan-1 in ARDS group were significantly higher than those in the non-ARDS group(Z=-6.046,-3.662;t=2.142,all P<0.01).ROC curve of the subjects showed that the AUC of serum IL-6,Wnt5a,syndecan-1 and their combined detection in predicting ARDS in patients with acute pancreatitis were 0.899(95%CI:0.809-0.989,P<0.01),0.826(95%CI:0.726-0.926,P<0.01),0.849(95%CI:0.765-0.933,P<0.01),0.956(95%CI:0.915-0.997,P<0.01),sensitivity was 86.7%,73.3%,86.7%,90%,specificity was 95.6%,86.7%,68.9%,93.3%.Conclusion:The combined detection of serum IL-6,Wnt5a,syndecan-1 has high clinical application value in predicting ARDS in patients with acute pancreatitis.