摘要
目的探讨急性胰腺炎(AP)患者巨噬细胞迁移抑制因子(MIF)、缺血修饰白蛋白(IMA)、白细胞介素-4(IL-4)/白细胞介素-2(IL-2)表达水平,分析上述指标与病情严重程度的相关性及其用于预测重症急性胰腺炎(SAP)的效能。方法选取自2018年3月至2020年4月收治的135例AP患者为研究对象,根据病情程度分为轻度组(n=45)、中度组(n=45)、重度组(n=45)。检测并比较3组间MIF、IMA、IL-4/IL-2水平。采用Logistic回归方程分析AP影响因素;采用Spearman分析MIF、IMA、IL-4/IL-2与AP严重程度的相关性;采用受试者工作特征(ROC)曲线分析MIF、IMA、IL-4/IL-2诊断AP及预测SAP的效能。结果重度组、中度组患者MIF、IMA高于轻度组,且重度组高于中度组,差异有统计学意义(P<0.05)。重度组、中度组患者IL-4/IL-2低于轻度组,且重度组低于中度组,差异有统计学意义(P<0.05)。MIF与IMA呈正相关(r=0.596,P<0.05);MIF与IL-4/IL-2呈负相关(r=-0.668,P<0.05);IMA与IL-4/IL-2呈负相关(r=-0.505,P<0.05)。Logistic回归分析结果显示,MIF、IMA、IL-4/IL-2为AP的影响因素(P<0.05)。Pearson相关性分析发现,MIF、IMA与AP严重程度呈正相关(r=0.900,r=0.665,P<0.05);IL-4/IL-2与AP严重程度呈负相关(r=-0.737,P<0.05)。MIF诊断AP的ROC曲线下面积为0.820,截断值为MIF>0.60 ng/ml;IMA诊断AP的ROC曲线下面积为0.829,截断值为IMA>73.74 U/ml;IL-4/IL-2诊断AP的ROC曲线下面积为0.806,截断值为IL-4/IL-2≤3.37;3者联合检测诊断AP的ROC曲线下面积为0.903。MIF预测SAP的ROC曲线下面积最大,为0.828,截断值为MIF>0.91 ng/ml。结论MIF、IMA、IL-4/IL-2存在相关性,且均为AP的影响因素,与AP及其严重程度有关,有望成为诊断AP及预测SAP的生物标志物。
Objective To investigate the relationship between macrophage migration inhibitory factor(MIF),ischemia modified albumin(IMA),interleukin-4(IL-4)/interleukin-2(IL-2)and acute pancreatitis(AP)and the efficacy of predicting severe acute pancreatitis(SAP).Methods A retrospective study was performed on 135 cases of patients with AP who were admitted from March 2018 to April 2020.According to the severity of disease,patients were divided into the mild group(n=45),moderate group(n=45)and severe group(n=45).MIF,IMA and IL-4/IL-2 levels were detected and compared between the three groups.Logistic regression equation was used to analyze the influencing factors of AP.Spearman was used to analyze the correlation between MIF,IMA,IL-4/IL-2 and AP severity.The ROC curve was used to analyze MIF,IMA,IL-4/IL-2 to diagnose AP and predict SAP performance.Results MIF and IMA of the severe and moderate groups were higher than those of the mild group,and the severe group was higher than that of the moderate group,with statistically significant differences(P<0.05).Il-4/IL-2 in the severe group and the moderate group was lower than that in the mild group and the severe group was lower than that in the moderate group(P<0.05).MIF was positively correlated with IMA(r=0.596,P<0.05);MIF was negatively correlated with IL-4/IL-2(r=-0.668,P<0.05);IMA was negatively correlated with IL-4/IL-2(r=-0.505,P<0.05).Logistic regression analysis showed that MIF,IMA and IL-4/IL-2 were the influencing factors of AP(P<0.05).Pearson correlation analysis found that MIF and IMA were positively correlated with the severity of AP(r=0.900,r=0.665,P<0.05);IL-4/IL-2 was negatively correlated with AP severity(r=-0.737,P<0.05).The area under ROC curve for MIF to diagnose AP was 0.820,and the cut-off value was MIF>0.60 ng/ml;the area under ROC curve for IMA to diagnose AP was 0.829,and the cut-off value was IMA>73.74 U/ml;the area under the ROC curve of IL-4/IL-2 in diagnosing AP was 0.806,and the cut-off value was IL-4/IL-2≤3.37;the area under ROC curve of the 3 combined detection and diagnosis of AP was 0.903.MIF predicted the maximum area under the ROC curve of SAP,which was 0.828,and the cut-off value was MIF>0.91 ng/ml.Conclusion There are correlations among MIF,IMA and IL-4/IL-2,all of which are influencing factors of AP and are related to AP and its severity,and are expected to be biomarkers for the diagnosis of AP and the prediction of SAP.
作者
崔永康
李爽
李书
CUI Yong-kang;LI Shuang;LI Shu(Department of Gastroenterology,Baoshan Integrated Traditional Chinese and Western Medicine Hospital,Shanghai 201900,China)
出处
《创伤与急危重病医学》
2020年第6期421-425,430,共6页
Trauma and Critical Care Medicine
基金
上海市宝山区医学特色专科和社区项目建设计划(BSZK-2018-A03)。
作者简介
第一作者:崔永康(1982-),男,上海人,主治医师;通信作者:李爽,E-mail:15800647366@163.com。
