Presepsin和sTREM-1对重症急性胰腺炎合并胰周感染的预测价值分析  

Predictive value of presepsin and sTREM-1 in severe acute pancreatitis complicated with peripancreatic infection

作　　者：龙江超 张泽奎[1] LONG Jiangchao;ZHANG Zekui(Department of Intensive Care Unit,People’s Hospital of Aba Tibetan and Qiang Autonomous Prefecture,Malkang,Sichuan,624000,China)

机构地区：[1]阿坝藏族羌族自治州人民医院重症科,四川马尔康624000

出　　处：《临床急诊杂志》2021年第5期325-328,334,共5页Journal of Clinical Emergency

摘　　要：目的:探讨Presepsin、可溶性髓系细胞触发受体1(sTREM-1)以及降钙素原(PCT)、C反应蛋白(CRP)对重症急性胰腺炎(SAP)合并胰周感染的预测价值。方法:选取2018年3月—2020年3月期间在我院接受治疗的SAP患者128例作为SAP组,根据患者是否并发胰周感染将其分为感染组(52例)和未感染组(76例)。另选取同期在我院体检的健康志愿者30例作为对照组。检测并比较所有研究对象的血清Presepsin、sTREM-1、PCT、CRP水平,Pearson法分析指标间的相关性,受试者操作特征曲线(ROC)分析各指标对SAP合并感染的预测价值。结果:SAP组的Presepsin、sTREM-1、PCT、CRP水平均明显高于对照组(P<0.05);感染组的Presepsin、sTREM-1、PCT、CRP水平均明显高于非感染组(P<0.05);Presepsin、sTREM-1、PCT、CRP水平过高均是SAP合并胰周感染的危险因素(P<0.05)。SAP患者血清Presepsin与sTREM-1、PCT、CRP均呈正相关(P<0.05),血清sTREM-1与Presepsin、PCT、CRP均呈正相关(P<0.05);ROC分析显示,CRP对SAP合并胰周感染的预测价值较低,曲线下面积低于0.7,而Presepsin、sTREM-1、PCT对SAP合并胰周感染均有一定的预测价值,曲线下面积均在0.7以上,其中Presepsin、sTREM-1的预测价值较高,曲线下面积分别为0.894(95%CI:0.834~0.953)、0.828(95%CI:0.748~0.909)。结论:Presepsin、sTREM-1可用于预测SAP合并胰周感染的风险,其预测价值均优于传统指标PCT及CRP。Objective: To investigate the predictive value of presepsin, sTREM-1, procalcitonin(PCT) and C-reactive protein(CRP) in severe acute pancreatitis(SAP) complicated with peripancreatic infection. Methods: One hundred and twenty eight SAP patients who were treated in our hospital from March 2018 to March 2020 were selected as the SAP group. According to whether the patients had concurrent peripancreatic infections, they were divided into infected group(52 cases) and non-infected group(76 cases). Besides, 30 healthy volunteers who received physical examination in our hospital during the same period were selected as the control group. The serum levels of Presepsin, sTREM-1, PCT and CRP of all subjects were detected and compared. Pearson method was used to analyze the correlation between indicators, and receiver operating characteristic curve(ROC) was used to analyze the predictive value of each index for SAP complicated with coinfection. Results: The levels of Presepsin, sTREM-1, PCT and CRP in the SAP group were significantly higher than those in the control group(P<0.05). The levels of Presepsin, sTREM-1, PCT and CRP in the infection group were significantly higher than those in the non-infected group(P<0.05). High levels of Presepsin, sTREM-1, PCT and CRP were the risk factors of SAP complicated with peripancreatic infection(P<0.05). Serum Presepsin of SAP patients was positively correlated with sTREM-1, PCT and CRP(P<0.05), and serum sTREM-1 was positively correlated with Presepsin, PCT and CRP(P<0.05). ROC analysis shows that CRP has a low predictive value for SAP complicated with peripancreatic infection, and the area under the curve was less than 0.7, while Presepsin, sTREM-1 and PCT had certain predictive value for SAP complicated with peripancreatic infection, and the area under the curve was above 0.7, of which Presepsin and sTREM-1 had higher predictive value, and the area under the curve was 0.894(95%CI: 0.834-0.953) and 0.828(95%CI: 0.748-0.909), respectively. Conclusion: Presepsin and sTREM-1 can be used

关 键 词：重症急性胰腺炎 感染 Presepsin 可溶性髓系细胞触发受体1 预测价值 

分 类 号：R657.51[医药卫生—外科学]