老年急性胰腺炎继发脓毒症外周血单免疫球蛋白白细胞介素-1受体相关蛋白表达及意义

Expression of single immunoglobulin interleukin-1 related receptor in peripheral blood of elderly severe acute pancreatitis patients with secondary sepsis and its significance

目的探究老年急性胰腺炎(SAP)继发脓毒症外周血单免疫球蛋白白细胞介素-1受体相关蛋白(SIGIRR)表达及意义。方法选择2019年9月-2021年9月丽水市人民医院急诊科收治的老年SAP继发脓毒症患者50例为研究组,另随机选择同期老年SAP未继发脓毒症患者50例为对照组。收集患者临床资料,采用酶联免疫吸附法检测外周血SIGIRR、TOLL样受体(TLR)2、TLR4和白细胞介素受体-1R(IL-1R)水平。结果研究组入院时床边急性胰腺炎严重指数(BISAP)高于对照组(P<0.05);研究组血清SIGIRR、TLR2、TLR4和IL-1R水平高于对照组(P<0.05),多因素Logistic回归分析结果显示BISAP、SIGIRR、TLR2、TLR4和IL-1R均为SAP继发脓毒症危险因素(P<0.05);受试者工作特征(ROC)曲线显示,血清SIGIRR、TLR2、TLR4和IL-1R水平预测继发脓毒症曲线下面积均>0.7,均具有统计学意义(P<0.05)。结论SIGIRR与TLRs及IL-1R协同参加老年SAP患者继发脓毒症发病过程,其水平对于预测脓毒症发生有一定临床意义。

OBJECTIVE To explore the expression of single immunoglobulin interleukin-1 related receptor(SIGIRR)in peripheral blood of the elderly severe acute pancreatitis(SAP)patients with secondary sepsis and analyze its significance.METHODS A total of 50 elderly SAP patients with secondary sepsis who were treated in emergency department of Lishui People′s Hospital from Sep 2019 to Sep 2021 were assigned as the study group,meanwhile,50 elderly SAP patients who did not have secondary sepsis were randomly chosen as the control group.The clinical data were collected from the patients,and the levels of peripheral blood SIGIRR,Toll-like receptor(TLR)2,TLR4 and interleukin-1R(IL-1R)were detected by enzyme-linked immunosorbent assay.RESULTS The bedside index for severity in acute pancreatitis(BISAP)of the study group was higher than that of the control group at the admission to hospital(P<0.05).The levels of serum SIGIRR,TLR2,TLR4 and IL-1R of the study group were higher than those of the control group(P<0.05).Multivariate logistic regression analysis indicated that BISAP,SIGIRR,TLR2,TLR4 and IL-1R were the risk factors for the secondary sepsis in the SAP patients(P<0.05).Receiver operating characteristic(ROC)curve analysis showed that the areas under curves(AUCs)of the serum SIGIRR,TLR2,TLR4 and IL-1R were more than 0.7 in prediction of secondary sepsis,and there was significant difference(P<0.05).CONCLUSION SIGIRR,TLRs and IL-1R synergistically participate the pathogenesis of secondary sepsis in the elderly patients with SAP,and the above indexes have certain clinical significance in prediction of secondary sepsis.