重症急性胰腺炎合并急性肾损伤患者IL-33表达水平及其临床意义  

Serum IL-33 expression in patients with severe acute pancreatitis complicated with acute kidney injury and its clinical significance

作　　者：白斌[1] 郑喜胜[1] 李长力[1] 贾明雅[1] 肖京[1] BAI Bin;ZHENG Xi-sheng;LI Chang-li;JIA Ming-ya;XIAO Jing(Department of Critical Care Medicine,Nanyang Central Hospital,Henan473000,China)

机构地区：[1]南阳市中心医院重症医学科,河南473000

出　　处：《中国卫生检验杂志》2022年第23期2917-2920,共4页Chinese Journal of Health Laboratory Technology

摘　　要：目的 探讨重症急性胰腺炎(SAP)合并急性肾损伤(AKI)患者血清IL-33水平及其影响因素,并评估IL-33预测SAP合并AKI患者预后的临床效能。方法 回顾性纳入本院2019年6月—2021年6月56例SAP患者、84例SAP合并AKI患者及健康体检者50例为研究对象。采用ELISA法检测血清IL-33水平,评估并比较3组研究对象血清IL-33水平的差异。结果 与SAP组和对照组比较,SAP合并AKI组患者血清IL-33水平升高(t值分别为10.685、25.794,P<0.05);SAP组患者血清IL-33水平高于对照组(t=12.408,P<0.05)。SAP合并AKI组患者血清IL-33水平与肌酐水平、Ranson评分均成正相关性(r值分别为0.62和0.54,P<0.05)。logistic结果显示,发生休克、发生SIRS及Ranson评分≥6分是SAP合并AKI患者血清IL-33水平升高的独立危险因素。ROC曲线结果显示,入院时SAP合并AKI患者血清IL-33水平预测患者死亡的临床效能显著,当IL-33的截断值为232.46μg/L,其敏感度为95.46%,特异度为90.23%,AUC为0.956(95%CI:0.842~0.981,P<0.05)。结论 SAP合并AKI患者血清IL-3水平升高,且IL-33水平在一定程度上可反映患者的病情严重程度及临床预后。Objective This study aims to investigate the serum level of IL-33 and its influencing factors in patients with severe acute pancreatitis(SAP) complicated with acute kidney injury(AKI). The clinical efficacy of serum IL-33 level in predicting the prognosis of patients with SAP complicated with AKI was also evaluated. Methods A total of 56 patients with SAP, 84 patients with SAP complicated with AKI and 50 healthy individuals for physical examination from June 2019 to June 2021 were included retrospectively. Serum IL-33 level was detected by enzyme-linked immunosorbent assay(ELISA). The differences of serum IL-33 levels were evaluated and compared among the three groups. Results When compared with SAP group and control group, the serum IL-33 level in SAP complicated with AKI group was significantly increased, with the differences statistically significant(t=10.685, t=25.794, P<0.05);the level of serum IL-33 in SAP group was significantly higher than control group, and the difference was statistically significant(t=12.408, P<0.05). There was a positive correlation between the serum levels of IL-33 and creatinine and Ranson score(r=0.62, r=0.54, P<0.05). Logistic results showed that incidence of shock, SIRS and Ranson scores ≥ 6 were independent risk factors for elevated serum IL-33 level in patients with SAP complicated with AKI. ROC curves showed that the serum IL-33 level in predicting the incidence of mortality in patients with SAP complicated with AKI was significant. When the cut-off value of IL-33 was 232.46 μg/L, the sensitivity, specificity and AUC area of IL-33 were 95.46%, 90.23% and 0.956(95%CI: 0.842-0.981, P<0.05), respectively. Conclusion The serum IL-33 level in SAP complicated with AKI is significantly increased, and the level of IL-33 can reflect the severity of the disease and the clinical prognosis in SAP complicated with AKI.

关 键 词：重症急性胰腺炎 急性肾损伤 白细胞介素-33 多因素分析 ROC曲线 

分 类 号：R446[医药卫生—诊断学]