sCD14-ST、PTX-3对重症急性胰腺炎合并胰周坏死感染的预测价值  

The predictive value of sCD14-ST and PTX-3 in severe acute pancreatitis complicated with peripancreatic necrosis and infection

作　　者：蔺军 冯宁 郭昆 LIN Jun;FENG Ning;GUO Kun(Department of Critical Care Medicine,Pingxiang People's Hospital,Pingxiang 337000,China)

机构地区：[1]萍乡市人民医院重症医学科,337000

出　　处：《天津医药》2022年第12期1306-1309,共4页Tianjin Medical Journal

基　　金：江西省卫生健康委科技计划(20204407)。

摘　　要：目的 探讨血清可溶性白细胞分化抗原14亚型(sCD14-ST)、正五聚蛋白-3(PTX-3)预测重症急性胰腺炎(SAP)合并胰周坏死感染的价值。方法 112例SAP患者根据胰周坏死感染情况分为感染组(54例)和未感染组(58例)。对感染组的患者进行病原菌的培养。采用酶联免疫吸附试验检测血清sCD14-ST、PTX-3、降钙素原(PCT)以及C反应蛋白(CRP)的表达情况。结果 感染组患者共检出61株病原菌,其中革兰阴性菌45株(73.77%),革兰阳性菌14株(22.95%),真菌2株(3.28%)。感染组血清sCD14-ST、PTX-3、PCT、CRP水平高于未感染组(P<0.05)。SAP患者血清sCD14-ST与PTX-3、PCT、CRP均呈正相关(P<0.05)。血清PTX-3与sCD14-ST、PCT、CRP均呈正相关(P<0.05)。sCD14-ST、PTX-3、PCT、CRP升高均是SAP患者发生胰周坏死感染的危险因素(P<0.05)。sCD14-ST、PTX-3、PCT、CRP预测SAP患者发生胰周坏死感染的曲线下面积分别为0.854(95%CI:0.784~0.925)、0.851(95%CI:0.780~0.923)、0.837(95%CI:0.756~0.919)、0.749(95%CI:0.654~0.844)。结论 SAP合并胰周坏死感染患者的血清sCD14-ST、PTX-3水平异常升高,且其表达水平与患者的感染风险密切相关,两者对SAP合并胰周坏死感染的预测价值较高。Objective To explore the predictive value of serum soluble leukocyte differentiation antigen subtype 14(sCD14 st) and pentamerin-3(PTX-3) in severe acute pancreatitis(SAP) complicated with peripancreatic necrosis infection.Methods A total of 112 SAP patients were selected and divided into the infection group(54 cases) and the non-infection group.Cultures of pathogenic bacteria were performed in patients of the infection group.Enzyme-linked immunosorbent assay was used to detect serum levels of sCD14 st,PTX-3,procalcitonin(PCT) and C-reactive protein(CRP).Results A total of 61 strains of pathogenic bacteria were detected in the infection group,including 45 strains of Gram-negative bacteria(73.77%),14 strains of Gram-positive bacteria(22.95%) and 2 strains of fungi(3.28%).The serum levels of sCD14-ST,PTX-3,PCT and CRP were significantly higher in the infected group than those in the non-infected group(P <0.05).Serum sCD14-ST was positively correlated with PTX-3,PCT and CRP in SAP patients(P <0.05).Serum PTX-3 was positively correlated with sCD14-ST,PCT and CRP(P<0.05).The high levels of sCD14-ST,PTX-3,PCT and CRP were the risk factors of peripancreatic necrosis infection in SAP patients(P<0.05).The areas under the curve of sCD14-ST,PTX-3,PCT and CRP predicting peripancreatic necrosis infection in SAP patients were 0.854(95%CI:0.784-0.925),0.851(95%CI:0.780-0.923),0.837(95%CI:0.756-0.919) and 0.749(95%CI:0.654-0.844) respectively.Conclusion The serum levels of sCD14-ST and PTX-3 are abnormally elevated in SAP patients with peripancreatic necrosis infection,and their expression levels are closely related to the risk of infection.Both of them have high predictive value for SAP patients with peripancreatic necrosis infection.

关 键 词：胰腺炎 急性坏死性 细菌感染和真菌病 预后 可溶性白细胞分化抗原14亚型 正五聚蛋白-3 

分 类 号：R657.51[医药卫生—外科学]