重症急性胰腺炎继发感染患者螺旋CT影像特征及sICAM-1、HBP、B7-H3的诊断价值

Spiral CT imaging characteristics of patients with severe acute pancreatitis secondary infection and diagnostic value of sICAM-1,HBP and B7-H3

目的探讨重症急性胰腺炎(SAP)继发感染患者螺旋电子计算机断层扫描(CT)影像特征及人可溶性细胞间黏附分子-1(sICAM-1)、肝素结合蛋白(HBP)、协同刺激分子B7家族3(B7-H3)的诊断价值。方法选取2020年7月-2023年7月山东第一医科大学附属人民医院接受治疗的SAP患者86例为研究对象,将继发感染的患者纳人研究组(37例),未继发感染的患者纳人对照组(49例);比较两组临床资料、螺旋CT影像特征、sICAM-1、HBP、B7-H3,并采用受试者工作特征(ROC)曲线分析sICAM-1、HBP、B7-H3预测SAP继发感染的效能。结果研究组各螺旋CT影像征象检出率均高于对照组(P<0.05);研究组血清sICAM-1、HBP和B7-H3分别为(988.76±71.54)ng/L、(37.87±15.65)ng/ml和(184.54±28.65)ng/L均高于对照组(P<0.05);sICAM-1、HBP、B7-H3和联合检测预测SAP继发感染的曲线下面积(AUC)分别为0.593、0.682、0.658和0.884,联合检测诊断价值优于单独检测(P<0.05)。结论继发感染与未继发感染的SAP患者均有相同螺旋CT影像学特征,但继发感染患者检出率更高,而血清sICAM-1、HBP、B7-H3水平在SAP继发感染的预测中具有较高应用价值,其中三者联合检测的预测价值最高。

OBJECTIVE To explore the imaging features of spiral computed tomography(CT)in patients with severe acute pancreatitis(SAP)secondary infection,and diagnostic value of human soluble intercellular adhesion molecule-1(sICAM-1),heparin binding protein(HBP),and co stimulatory molecule B7 family 3(B7-H3).METHODS Eighty-six SAP patients who received treatment at the Affiliated People's Hospital of Shandong First Medical University from Jul.2020 to Jul.2023 were selected as the study subjects,and the patients with secondary infections were included in the study group(37 cases)and those without secondary infections were included in the control group(49 cases).The clinical data,spiral CT imaging features,sICAM-1,HBP,and B7-H3 of two groups were compared between two groups,and the efficacy of sICAM-1,HBP,and B7-H3 in predicting secondary infections in SAP were analyzed by receiver operating characteristic(ROC)curves.RESULTS The detection rate of spiral CT imaging features in the study group was higher than that of the control group(P<0.05).The levels of serum sICAM-1,HBP,and B7-H3 in the study group were higher than those of the control group(P<0.05).The area under curve(AUC)of sICAM-1,HBP,B7-H3 and combined detection for predicting secondary infection in SAP were 0.593,0.682,0.658,and 0.884,respectively,and the diagnostic value of the combined detection was superior to the single detection(P<O.05).CONCLUSION Both secondary infected and uninfected SAP patients had the same spiral CT imaging features,but the detection rate was higher in secondary infected patients,while serum sICAM-1,HBP,B7-H3 levels had a high application value in the prediction of secondary infection in SAP,with the combination of the three having the highest predictive value.