胰管支架置入术后急性胰腺炎患者的炎症因子、氧化应激反应指标与预后的相关性分析  

Correlation analysis of infl ammatory factors,oxidative stress response indexes and prognosis in patients with acute pancreatitis after pancreatic duct stenting

作　　者：万思远 李乐辉 廖薇薇 林志星 Wan Siyuan;Li Lehui;Liao Weiwei;Lin Zhixing(Department of Emergency,The First Affiliated Hospital of Hainan Medical University,Haikou Hainan 570000,China;Department of Gastroenterology,The Second Affiliated Hospital of Hainan Medical University,Haikou Hainan 570100,China;Department of Critical Care Medicine,The First Affiliated Hospital of Hainan Medical University,Haikou Hainan 570000,China)

机构地区：[1]海南医学院第一附属医院急诊科,海南海口570000 [2]海南医学院第二附属医院消化内镜科,海南海口570100 [3]海南医学院第一附属医院重症医学科,海南海口570000

出　　处：《中国医刊》2025年第1期53-56,共4页Chinese Journal of Medicine

基　　金：海南省卫生健康行业科研项目(21A200054)。

摘　　要：目的探讨胰管支架置入术后急性胰腺炎患者的炎症因子、氧化应激反应指标与预后的相关性。方法回顾性分析2019年6月至2023年6月海南医学院第一附属医院收治的82例接受胰管支架置入术治疗的急性胰腺炎患者的临床资料,根据预后不同分为预后不良组(预后不良,28例)和预后良好组(预后良好,54例)。比较分析两组患者的炎症因子[白介素-6(IL-6)、白介素-8(IL-8)、高敏C反应蛋白(hs-CRP)、降钙素原(PCT)]水平、氧化应激反应指标[丙二醛(MDA)、超氧化物歧化酶(SOD)、谷胱甘肽过氧化物酶(GSH-Px)]。采用多因素logistic回归方法分析胰管支架置入术后急性胰腺炎患者预后不良的独立影响因素。采用受试者操作特征(ROC)曲线分析炎症因子、氧化应激反应指标对胰管支架置入术后急性胰腺炎患者预后不良的预测价值。结果两组患者的IL-8水平比较差异无统计学意义(P>0.05);预后不良组患者的IL-6、hs-CRP、PCT、MDA水平均高于预后良好组,GSH-Px、SOD水平均低于预后良好组,差异均有统计学意义(P<0.05)。多因素logistic回归分析结果显示,IL-6、hs-CRP、PCT、MDA均是胰管支架置入术后急性胰腺炎患者预后不良的独立危险因素(P<0.05),GSH-Px、SOD均是胰管支架置入术后急性胰腺炎患者预后不良的独立保护因素(P<0.05)。ROC曲线分析结果显示,IL-6预测胰管支架置入术后急性胰腺炎患者预后不良的曲线下面积为0.703,大于hs-CRP、PCT、MDA、GSH-Px、SOD等指标(P<0.05)。结论血清IL-6、hs-CRP、PCT、MDA、GSH-Px、SOD与胰管支架置入术后急性胰腺炎患者的预后不良显著相关,监测相关炎症因子、氧化应激反应指标对患者的预后不良具有较好预测价值。Objective To investigate the correlation between inflammatory factors,oxidative stress response indexes and prognosis in patients with acute pancreatitis after pancreatic duct stenting.Method The clinical data of 82 patients with acute pancreatitis treated with pancreatic duct stenting admitted to The First Affiliated Hospital of Hainan Medical University from June 2019 to June 2023 were retrospectively analyzed,and they were divided into poor prognosis group(28 patients with poor prognosis)and good prognosis group(54 patients with good prognosis)according to different prognosis.The inflammatory factors(IL-6,IL-8,hs-CRP,PCT)and oxidative stress response indexes(MDA,SOD,GSH-Px)in the two groups were compared and analyzed.Multivariate logistic regression was used to analyze the independent influencing factors of poor prognosis in patients with acute pancreatitis after pancreatic duct stenting.ROC curve was used to analyze the prognostic value of inflammatory factors and oxidative stress response indexes in patients with acute pancreatitis after pancreatic duct stenting.Result There was no significant difference in IL-8 level between the two groups(P>0.05).The levels of IL-6,hs-CRP,PCT and MDA in the poor prognosis group were higher than those in the good prognosis group,while the levels of GSH-Px and SOD were lower than those in the good prognosis group,with statistical significance(P<0.05).Multivariate logistic regression analysis showed that IL-6,hs-CRP,PCT and MDA were independent risk factors for poor prognosis in patients with acute pancreatitis after pancreatic duct stenting(P<0.05).GSH-Px and SOD were independent protective factors for poor prognosis in patients with acute pancreatitis after pancreatic duct stenting(P<0.05).ROC curve analysis results showed that the area under the curve of IL-6 in predicting poor prognosis of patients with acute pancreatitis after pancreatic duct stenting was 0.703,which was larger than hs-CRP,PCT,MDA,GSH-Px,SOD(P<0.05).Conclusion Serum IL-6,hs-CRP,PCT,MDA,GSH-Px and SOD

关 键 词：胰管支架置入术 急性胰腺炎 炎症因子 氧化应激反应 预后 

分 类 号：R576[医药卫生—消化系统]