联合检测NLR、IL-6、CRP、PCT对急性胰腺炎的诊断价值  

Value of combined detection of NLR, IL-6, CRP and PCT in diagnosis of acute pancreatitis

作　　者：梁育飞[1] 李春秀 李春英[1] Yu-fei Liang;Chun-xiu Li;Chun-ying Li(Department of Gastroenterology,Cangzhou Central Hospital,Cangzhou,Hebei 061001,China;Department of Pediatrics,Cangxian Hospital,Cangzhou,Hebei 061007,China)

机构地区：[1]河北省沧州市中心医院消化内科,河北沧州061001 [2]河北省沧州市沧县医院儿科,河北沧州061007

出　　处：《中国现代医学杂志》2018年第31期64-68,共5页China Journal of Modern Medicine

摘　　要：目的探讨炎性指标中性粒细胞/淋巴细胞比值(NLR)、白细胞介素6(IL-6)、C反应蛋白(CRP)及降钙素原(PCT)在急性胰腺炎(AP)中的表达及对该疾病严重性的诊断价值。方法选取河北省沧州市中心医院AP患者99例(重症AP 34例、轻症AP 65例)和体检健康者38例,检测白细胞计数(WBC)、中性粒细胞计数(NE)、淋巴细胞计数(LYM)、单核细胞计数(MON)、NLR水平,了解不同等级体重指数(BMI)分组中各指标的变化,AP患者同时检测IL-6、CRP、PCT及血淀粉酶(AMY)水平,绘制ROC曲线,预测炎性指标的临床应用价值。结果急性胰腺炎中WBC、NLR、NE、MON均高于对照组,而LYM低于对照组(P<0.05)。不同等级BMI分组中的WBC、NLR、NE、LYM、MON差异无统计学意义(P>0.05)。重症急性胰腺炎组(SAP组)中WBC、NLR、NE、LYM、MON、PCT、CRP、IL-6、AMY与轻症急性胰腺炎组(MAP组)比较,差异有统计学意义(P<0.05)。淋巴细胞与SAP呈负相关(r=-0.240,P=0.017),其余均呈正相关。对于AP严重程度诊断效能最大的是IL-6(敏感性70.6%,特异性87.7%,AUC=0.859),其次是PCT(敏感性88.2%,特异性78.5%,AUC=0.848)。结论 IL-6、NLR、CRP、PCT的变化与AP的病情严重程度有关,PCT的敏感性最高,而NLR的特异性最强,IL-6对预测AP严重程度具有很大临床价值。Objective To investigate the diagnostic value of neutrophil/lymphocyte ratio(NLR),and the expressions of interleukin 6(IL-6),C-reactive protein(CRP)and procalcitonin(PCT)in acute pancreatitis(AP).Methods In this study 99 cases of AP(34 cases of severe acute pancreatitis and 65 cases of mild acute pancreatitis)and 38 healthy controls in Cangzhou Central Hospital were selected.White blood cell count(WBC),neutrophil count(NE),lymphocyte count(LYM),monocyte count(MON),and NLR were measured to understand the changes of various indexes in different grades of body mass index(BMI);simultaneously,serum levels of IL-6,CRP,PCT and amylase(AMY)in the patients with AP were detected,the ROC curves were drawn to predict the clinical value of the inflammatory indexes.Results Compared to the normal control group,the levels of NLR,NE,WBC and MON were significantly higher,but LYM was lower in the AP group(P<0.05).There was no significant difference in NLR,NE,WBC,LYM or MON among different BMI groups(P>0.05).The indexes of NLR,NE,WBC,LYM,MON,PCT,CRP,IL-6 and AMY in the severe acute pancreatitis(SAP)group were statistically different from those in the mild acute pancreatitis group(P<0.05).LYM was negatively correlated with SAP(r=-0.240,P=0.017),and the rest were positively correlated with SAP.The diagnostic efficiency of IL-6 for AP was the highest(sensitivity 70.6%,specificity 87.7%,AUC=0.859),followed by that of PCT(sensitivity 88.2%,specificity 78.5%,AUC=0.848).Conclusions The changes in the levels of IL-6,NLR,CRP and PCT are related to the severity of AP;PCT has the highest sensitivity,NLR has the highest specificity,while IL-6 has the greatest clinical value in predicting the severity of AP.

关 键 词：急性胰腺炎 白细胞介素6 中性粒细胞与淋巴细胞比值 C反应蛋白 预测价值 

分 类 号：R576[医药卫生—消化系统]