免疫指标检测在高脂血症性急性胰腺炎病情评估中的应用  

Application of immune index detection in the prediction of hyperlipidemic acute pancreatitis

作　　者：鲍峰[1] 李婷 吴利蓉[1] 赵平武[2] 向春华[1] 邓志刚[1] 李国强[1] 智星[1] 刘文[1] BAO Feng;LI Ting;WU Li-rong;ZHAO Ping-wu;XIANG Chun-hua;DENG Zhi-gang;LI Guo-qiang;ZHI Xing;LIU Wen(Department of General Surgery,Mianyang Central Hospital,Mianyang 621000,China;Department of General Surgery,Mianyang Hospital of Traditionanl Chinese Medicine,Mianyang 621000,China)

机构地区：[1]绵阳市中心医院普外科,四川绵阳621000 [2]绵阳市中医医院普外科,四川绵阳621000

出　　处：《中国现代普通外科进展》2021年第11期869-872,878,共5页Chinese Journal of Current Advances in General Surgery

基　　金：四川省绵阳市科技局应用技术研究与开发项目(17YFHM002)。

摘　　要：目的:评价免疫指标与高脂血症性急性胰腺炎(HLAP)病情轻重程度的相关性。方法:收集2017年6月—2019年12月绵阳市中心医院收治的116例HLAP患者。按照病情轻重程度分为轻度HLAP组(MHAP组)和重度HLAP组(SHAP组),收集其入院时一般临床资料和血清PCT、CRP、TNF-α、IL-6、IL-10水平。Logistic回归分析用于确定SHAP的危险因素。结果:与MHAP组相比,SHAP组PCT[(2.1±0.8)μg/L比(1.2±0.5)μg/L,P<0.001]、CRP[(14.3±2.7)mg/mL比(8.9±2.5)mg/L,P<0.001]、IL-6[(19.4±3.9)pg/mL比(10.0±2.4)pg/mL,P<0.001]、IL-10[(18.2±2.5)pg/mL比(14.5±1.8)pg/mL,P<0.001]、TNF-α[(16.4±2.2)pg/mL比(10.4±1.0)pg/mL,P<0.001]水平均较高,差异有统计学意义(P<0.05)。多因素分析显示PCT≥1.5μg/L(OR=9.1,95%CI:4.0~20.6,P=0.004),CRP≥11 mg/L(OR=27.3,95%CI:1.3~54.9,P=0.031),IL-6≥12 pg/mL(OR=26.9,95%CI:8.4~86.0,P=0.002),IL-10≥16 pg/mL(OR=13.3,95%CI:5.1~34.8,P=0.003),TNF-α≥11 pg/mL(OR=22.5,95%CI:1.3~38.9,P=0.032)是SHAP的独立危险因素。结论:PCT、CRP、TNF-α、IL-6和IL-10是与SHAP相关的独立的危险因素,通过对免疫指标的联合检测有助于SHAP的早期诊断和合理治疗,具有一定的临床应用价值。Objective:To determine the prediction value of immune index detection for severity hyperlipidemic acute pancreatitis(HLAP).Methods:116 patients with HLAP admitted to Mianyang Central Hospital from June 2017 to December 2019 were collected.According to the severity of the disease,the patients were divided into mild HLAP group(MHAP group)and severe HLAP group(SHAP group).The clinical data and serum PCT,CRP,TNF-α,IL-6,IL-10 were collected after in hospital.Logistic regression analysis was used to identify the risk factors of SHAP.Results:Compared with MHAP group,the concentrations of PCT[(2.1±0.8)μg/L vs(1.2±0.5)μg/L,P<0.001],CRP[(14.3±2.7)mg/L vs(8.9±2.5)mg/L,P<0.001],IL-6[(19.4±3.9)pg/mL vs(10.0±2.4)pg/mL,P<0.001],IL-10[(18.2±2.5)pg/mL vs(14.5±1.8)pg/mL,P<0.001]and TNF-α[(16.4±2.2)pg/mL vs(10.4±1.0)pg/mL,P<0.001]in SHAP group were significantly higher(P<0.05).Multivariate analysis showed that PCT≥1.5μg/L(OR=9.1,95%CI:4.0-20.6,P=0.004),CRP≥11 mg/L(OR=27.3,95%CI:1.3-54.9,P=0.031),IL-6≥12 pg/mL(OR=26.9,95%CI:8.4-86.0,P=0.002),IL-10≥16 pg/mL(OR=13.3,95%CI:5.1-34.8,P=0.003)and TNF-α≥11 pg/mL(OR=22.5,95%CI:1.3-38.9,P=0.032)were independent risk factors for SHAP.Conclusion:PCT,CRP,TNF-α,IL-6 and IL-10 were independent risk factors associated with SHAP.The combined detection of immune indexes is helpful to the early diagnosis and reasonable treatment for SHAP,worthy of application.

关 键 词：炎症因子 免疫标志物 高脂血症 急性胰腺炎 

分 类 号：R657.51[医药卫生—外科学]