血清sIL-2R、IL-27及IL-36对重症急性胰腺炎并发急性肾损伤的预测价值  

The predictive value of serum sIL-2R,IL-27 and IL-36 in severe acute pancreatitis complicated with acute kidney injury

作　　者：肖华 李志霞[1] 周君 XIAO Hua;LI Zhixia;ZHOU Jun(Department of Clinical laboratory,Sanya Central Hospital(Hainan Third People′s Hospital),Sanya,Hainan 572000,China)

机构地区：[1]三亚中心医院(海南省第三人民医院)检验科,海南三亚572000

出　　处：《检验医学与临床》2024年第11期1617-1621,共5页Laboratory Medicine and Clinic

摘　　要：目的分析血清可溶性白细胞介素2受体(sIL-2R)、白细胞介素(IL)-27及IL-36对重症急性胰腺炎(SAP)并发急性肾损伤(AKI)的预测价值。方法选取2020年1月至2023年3月该院收治的SAP患者126例作为研究对象,根据其是否并发AKI分为AKI组(45例)和非AKI组(81例)。比较两组临床资料。采用多因素Logistic回归分析影响SAP患者并发AKI的危险因素,绘制受试者工作特征(ROC)曲线分析血清sIL-2R、IL-27及IL-36单独及3项指标联合检测对SAP患者并发AKI的预测价值。采用Pearson相关分析AKI患者血清sIL-2R、IL-27及IL-36水平与肝、肾功能指标的相关性。结果两组住院时间、序贯器官衰竭评估(SOFA)评分、急性生理学与慢性健康状况评分系统Ⅱ(APACHEⅡ)评分、血红蛋白、尿量、血肌酐(Scr)、尿素氮、清蛋白、sIL-2R、IL-27及IL-36水平比较,差异均有统计学意义(P<0.05)。多因素Logistic回归分析结果显示,清蛋白水平降低,SOFA评分、APACHEⅡ评分、Scr、尿素氮、sIL-2R、IL-27及IL-36水平升高是SAP患者并发AKI的危险因素(P<0.05)。ROC曲线分析结果显示,血清sIL-2R、IL-27及IL-36单独预测SAP患者并发AKI的曲线下面积(AUC)分别为0.815、0.768、0.861,3项指标联合预测SAP患者并发AKI的AUC为0.925。Pearson相关分析结果显示,AKI组患者血清sIL-2R、IL-27及IL-36水平与SOFA评分、APACHEⅡ评分、Scr、尿素氮水平均呈正相关(P<0.05);AKI组患者血清sIL-2R、IL-27及IL-36水平与清蛋白水平均呈负相关(P<0.05)。结论血清sIL-2R、IL-27及IL-36水平升高是影响SAP患者并发AKI的危险因素,3项指标联合检测对预测SAP并发AKI具有较好的价值。Objective To investigate the predictive value of serum soluble interleukin-2 receptor(sIL2R),interleukin(IL)-27 and IL-36 levels in severe acute pancreatitis(SAP)complicated with acute kidney injury(AKI).Methods A total of 126 SAP patients admitted to the hospital from January 2020 to March 2023 were selected as the research objects.According to whether they were complicated with AKI,they were divided into AKI group(45 cases)and non-AKI group(81 cases).The clinical data of the two groups were compared.Multivariate Logistic regression was used to analyze the risk factors of SAP patients complicated with AKI.The receiver operating characteristic(ROC)curve was drawn to analyze the predictive value of serum sIL-2R,IL-27 and IL-36 alone and combined detection of the three indexes for SAP patients complicated with AKI.Pearson correlation analysis was used to analyze the correlation between serum sIL-2R,IL-27,IL-36 levels and liver and kidney function indexes in patients with AKI.Results The length of hospital stay,Sequential Organ Failure Assessment(SOFA)score,Acute Physiology and Chronic Health EvaluationⅡ(APACHEⅡ)score,hemoglobin,urine volume,serum creatinine(Scr),urea nitrogen,albumin,sIL-2R,IL-27 and IL-36 levels were compared between the two groups,and the differences were statistically significant(P<0.05).Multivariate Logistic regression analysis results showed that decreased albumin level,increased SOFA score,APACHEⅡscore,Scr,urea nitrogen,sIL-2R,IL-27 and IL-36 levels were risk factors for SAP patients complicated with AKI(P<0.05).ROC curve analysis showed that the area under the curve(AUC)of serum sIL-2R,IL-27 and IL-36 for predicting SAP patients complicated with AKI was 0.815,0.768 and 0.861 respectively.The AUC of the three indexes combined for predicting SAP patients complicated with AKI was 0.925.Pearson correlation analysis showed that serum sIL-2R,IL-27 and IL-36 levels of patients in AKI group were positively correlated with SOFA score,APACHEⅡscore,Scr and urea nitrogen levels(P<0.05).The serum

关 键 词：重症急性胰腺炎 急性肾损伤 可溶性白细胞介素2受体 白细胞介素-27 白细胞介素-36 

分 类 号：R615.51[医药卫生—外科学] R444.61[医药卫生—临床医学]