重症急性胰腺炎患者并发腹腔感染病原菌和sRAGE、Ghrelin与MCP-1水平及其预测价值  

Pathogenic bacteria in patients with severe acute pancreatitis complicated with abdominal infection and the predictive value of sRAGE, Ghrelin and MCP-1

作　　者：谢敏 吕睿 肖红娟[2] 游长江 高丹 张攀 XIE Min;LYU Rui;XIAO Hong-juan;YOU Chang-jiang;GAO Dan;ZHANG Pan(Jianyang People's Hospital,Chengdu,Sichuan 641400,China;不详)

机构地区：[1]简阳市人民医院重症医学科,四川成都641400 [2]四川省人民医院,四川成都641400 [3]成都市龙泉驿区中医医院,四川成都641400 [4]简阳市中医医院,四川成都641400 [5]邛崃市医疗中心医院,四川邛崃611500

出　　处：《中华医院感染学杂志》2024年第11期1697-1701,共5页Chinese Journal of Nosocomiology

基　　金：四川省科研基金资助项目(2021JH03400104)。

摘　　要：目的 分析重症急性胰腺炎患者并发腹腔感染病原菌和可溶性糖基化终末产物受体(sRAGE)、生长激素释放肽(Ghrelin)、单核细胞趋化因子蛋白-1(MCP-1)及其预测价值.方法 纳入2021年1月-2023年1月简阳市人民医院收治的重症急性胰腺炎患者186例进行研究,根据并发腹腔感染情况分为腹腔感染组(55例)、非腹腔感染组(131例);分析重症急性胰腺炎患者并发腹腔感染的病原菌,比较两组及不同感染程度患者血清sRAGE、Ghrelin、MCP-1水平,绘制受试者工作特征(ROC)曲线分析sRAGE、Ghrelin、MCP-1及其对其预测价值.结果 55例重症急性胰腺炎并发腹腔感染患者共培养分离病原菌68株,其中革兰阴性菌34株,革兰阳性菌24株,真菌10株,以肺炎克雷伯菌和屎肠球菌为主;腹腔感染组血清sRAGE、Ghrelin、MCP-1高于非腹腔感染组(P<0.05);严重感染急性胰腺炎并发腹腔感染患者血清sRAGE、Ghrelin、MCP-1高于轻中重度感染患者(P<0.05);绘制ROC曲线,sRAGE、Ghrelin、MCP-1单独检测及联合检测预测重症急性胰腺炎患者并发腹腔感染的曲线下面积(AUC)为0.748、0.726、0.715和0.941,联合检测诊断价值最高.结论 重症急性胰腺炎患者并发腹腔感染风险较高,随着感染的发生及进展血清sRAGE、Ghrelin、MCP-1表达增加,联合检测有助于重症急性胰腺炎患者并发腹腔感染的诊断.OBJECTIVE To analyze the pathogenic bacteria in patients with severe acute pancreatitis complicated with abdominal infection and the predictive value of soluble receptor for advanced glycation end(sRAGE),growth hormone releasing peptide(Ghrelin)and monocyte chemokine protein-1(MCP-1).METHODS Totally 186 patients with severe acute pancreatitis admitted to the People's Hospital from Jan.2021 to Jan.2023 were included in the study and were divided into the intraperitoneal infection group(55 cases)and non-intraperitoneal infection group(131 cases)according to their complicity with intraperitoneal infection.The pathogenic bacteria in patients with severe acute pancreatitis complicated with abdominal infection were analyzed,serum sRAGE,Ghrelin and MCP-1 levels were compared between the two groups and patients with different levels of infection,and receiver operating characteristic (ROC) curve was plotted to analyze the predictive value of sRAGE, Ghrelin and MCP-1 aloneand in combination. RESULTS In 55 patients with severe acute pancreatitis complicated with abdominal infection,a total of 68 strains of pathogenic bacteria were isolated and co-cultured, 34 of which were gram-negativebacteria, 24 were gram-positive bacteria, and 10 were fungi, with Klebsiella pneumoniae and Enterococcus faeciumbeing predominant. The serum levels of sRAGE, Ghrelin and MCP-1 in the intraperitoneal infection groupwere higher than those in the non-intraperitoneal infection group (P<0.05). Serum levels of sRAGE, Ghrelin andMCP-1 in patients with severe acute pancreatitis complicated with abdominal infection were higher than those inpatients with mild to severe infection (P<0.05). Intraperitoneal infection was included as positive and non-intraperitonealinfection as negative. ROC curve was plotted, and the area under the curve (AUC) of sRAGE, Ghrelin,MCP-1 alone and combined detection for predicting concomitant abdominal infections in patients with severe acutepancreatitis were 0.748, 0.726, 0.715, and 0.941, respectively, and the combined dete

关 键 词：重症急性胰腺炎 腹腔感染 可溶性糖基化终末产物受体 生长激素释放肽 单核细胞趋化因子蛋白-1 预测价值 

分 类 号：R657.51[医药卫生—外科学]