血清抵抗素、丙二醛、IL-6联合检测对急性胰腺炎严重程度的预测价值

doi:10.3969/j.issn.1004-583X.2023.05.004

摘要/Abstract

摘要：

目的探讨联合检测血清脂肪因子抵抗素、脂质过氧化产物丙二醛和炎症因子白细胞介素6(Interleukin 6, IL-6)水平对急性胰腺炎(Acute pancreatitis,AP)严重程度的预测价值。方法选取2022年1月至2022年11月在河北省人民医院消化内科住院治疗的AP患者120例,将患者分为3组:轻症急性胰腺炎(Mild acute pancreatitis,MAP)组、中度重症急性胰腺炎(Moderate severe acute pancreatitis,MSAP)组、重症急性胰腺炎(Severe acute pancreatitis,SAP)组。收集患者一般资料,在患者发病48~72小时内抽取静脉血4ml,采用ELISA方法检测血清抵抗素、丙二醛、IL-6水平。结果 3组血清抵抗素、丙二醛、IL-6水平差异有统计学意义(P<0.05)。抵抗素、丙二醛、IL-6三者间呈显著线性相关性(P<0.01)。血清抵抗素、丙二醛、IL-6预测SAP(MSAP+SAP)的ROC曲线下面积分别为0.850、0.774、0.817,敏感度和特异度分别为77.80%和78.80%;90.70%和62.10%;72.20%和83.30%。联合检测血清抵抗素、丙二醛、IL-6预测SAP(MSAP+SAP)的ROC曲线下面积为0.890,敏感度和特异度分别为74.10%和90.90%。结论 SAP患者血清抵抗素、丙二醛、IL-6均明显升高,联合检测脂肪因子抵抗素、脂质过氧化物丙二醛、炎症因子IL-6评估AP严重程度具有较高的效能,或许可以成为预测AP严重程度的一种新方法。

关键词: 急性胰腺炎, 脂肪组织, 抵抗素, 丙二醛, 白细胞介素6

Abstract:

Objective To investigate the predictive value of a combination detection of serum resistin, malondialdehyde (MDA) and interleukine-6 (IL-6) in predicting the severity of acute pancreatitis (AP). Methods A total of 120 AP patients hospitalized in the Department of Gastroenterology, Hebei General Hospital, from January 2022 to November 2022 were selected and divided into three groups: mild acute pancreatitis group (MAP), moderately severe acute pancreatitis (MSAP) and severe acute pancreatitis group (SAP). Baseline characteristics of them were collected, and 4 ml of venous blood was drawn within 48-72 hours of onset of illness to measure serum levels of resistin, MDA and IL-6 by enzyme-linked immunosorbent assay (ELISA). Results There were significant differences in serum resistin, MDA and IL-6 levels among the MAP, MSAP and SAP group (P<0.05). There was a significant linear correlation among serum resistin, MDA and IL-6 levels (P<0.01). The area under the receiver operating characteristic (ROC) curves (AUC) of detecting serum resistin, MDA and IL-6 in predicting SAP (including both MSAP and SAP) was 0.850, 0.774 and 0.817, respectively, with the sensitivity of 77.80%, 90.70% and 72.20%, respectively, and the specificity of 78.80%, 62.10% and 83.30%, respectively. The AUC of a combination detection of them in predicting SAP (MSAP+SAP) was 0.890, with the sensitivity and specificity of 74.10% and 90.90%, respectively. Conclusion Serum resistin, MDA and IL-6 levels are significantly elevated in SAP patients, and their combination detection has a high efficacy in predicting the severity of AP, which may be used as a novel predictive method.

Key words: acute pancreatitis, adipose tissue, resistin, malondialdehyde, interleukin-6

中图分类号:

R576

于雪华, 张宁, 吴婧, 孙惠, 赵云红, 刘改芳. 血清抵抗素、丙二醛、IL-6联合检测对急性胰腺炎严重程度的预测价值[J]. 临床荟萃, 2023, 38(5): 412-416.

Yu Xuehua, Zhang Ning, Wu Jing, Sun Hui, Zhao Yunhong, Liu Gaifang. Predictive value of a combiniton detection of serum resistin, malondialdehyde and IL-6 tests in predicting the severity of acute pancreatitis[J]. Clinical Focus, 2023, 38(5): 412-416.

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链接本文: https://huicui.hebmu.edu.cn/CN/10.3969/j.issn.1004-583X.2023.05.004

https://huicui.hebmu.edu.cn/CN/Y2023/V38/I5/412

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参考文献 33

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指标	MAP(n=66)	MSAP(n=30)	SAP(n=24)	χ²/F值	P值
性别(例)				0.45	0.799
男性	51	22	17
女性	15	8	7
年龄(岁)	44.73±14.64	46.00±13.99	45.79±16.02	0.71	0.708
BMI(kg/m²)	26.31±4.22	27.32±4.17	27.18±4.40	2.25	0.338
病因(例)				3.20	0.806
胆源性	22	11	6
酒精性	11	3	5
高脂血症性	31	15	11
特发性	2	1	2

指标	MAP(n=66)	MSAP(n=30)	SAP(n=24)	χ²/F值	P值
性别(例)				0.45	0.799
男性	51	22	17
女性	15	8	7
年龄(岁)	44.73±14.64	46.00±13.99	45.79±16.02	0.71	0.708
BMI(kg/m²)	26.31±4.22	27.32±4.17	27.18±4.40	2.25	0.338
病因(例)				3.20	0.806
胆源性	22	11	6
酒精性	11	3	5
高脂血症性	31	15	11
特发性	2	1	2

指标	MAP组(n=66)	MSAP组(n=30)	SAP组(n=24)	χ²值	P值
抵抗素(ng/ml)	462.87(251.20, 680.92)	854.25(654.39, 1116.56)	1167.60(762.01, 2055.89)	45.97	0.000
丙二醛(ng/ml)	261.80(160.24, 555.60)	507.55(361.50, 702.17)	863.41(522.13, 1096.78)	31.07	0.000
IL-6(pg/ml)	14.58(8.12, 27.64)	35.43(14.69, 42.98)	46.55(36.05, 65.97)	43.42	0.000
TC(mmol/L)	4.84(4.07, 6.50)	5.44(4.59, 7.37)	5.28(4.06, 11.81)	3.53	0.173
TG(mmol/L)	2.93(1.09, 6.99)	2.53(1.14, 8.18)	5.36(0.87, 21.66)	1.40	0.492
CRP(mg/L)	37.58(21.60, 102.06)	86.50(64.74, 181.01)	239.83(77.97, 334.70)	36.32	0.000
PCT(ng/ml)	0.11(0.06, 0.36)	0.33(0.18, 1.57)	1.19(0.75, 3.06)	28.09	0.000

指标	MAP组(n=66)	MSAP组(n=30)	SAP组(n=24)	χ²值	P值
抵抗素(ng/ml)	462.87(251.20, 680.92)	854.25(654.39, 1116.56)	1167.60(762.01, 2055.89)	45.97	0.000
丙二醛(ng/ml)	261.80(160.24, 555.60)	507.55(361.50, 702.17)	863.41(522.13, 1096.78)	31.07	0.000
IL-6(pg/ml)	14.58(8.12, 27.64)	35.43(14.69, 42.98)	46.55(36.05, 65.97)	43.42	0.000
TC(mmol/L)	4.84(4.07, 6.50)	5.44(4.59, 7.37)	5.28(4.06, 11.81)	3.53	0.173
TG(mmol/L)	2.93(1.09, 6.99)	2.53(1.14, 8.18)	5.36(0.87, 21.66)	1.40	0.492
CRP(mg/L)	37.58(21.60, 102.06)	86.50(64.74, 181.01)	239.83(77.97, 334.70)	36.32	0.000
PCT(ng/ml)	0.11(0.06, 0.36)	0.33(0.18, 1.57)	1.19(0.75, 3.06)	28.09	0.000

指标	抵抗素	丙二醛	IL-6
抵抗素	1.000	0.437^*	0.574^*
丙二醛	0.437^*	1.000	0.343^*
IL-6	0.574^*	0.343^*	1.000
CRP	0.373^*	0.146	0.356^*
PCT	0.342^*	0.283^*	0.370^*
BMI	0.164	0.396^*	0.037
TC	-0.002	-0.102	0.026
TG	0.038	-0.072	0.061