摘要
目的探讨重症急性胰腺炎(SAP)患者血清降钙素原(PCT)、C-反应蛋白(CRP)、白细胞介素6(IL-6)水平变化及其与并发细菌感染的关系。方法选取2015年1月至2018年1月收治的SAP患者220例,依据是否并发细菌感染分为并发组(n=100例)和无发组(n=120例),2组均检测血清PCT、CRP、IL-6水平,分析2组血清PCT、CRP、IL-6水平变化及其与并发细菌感染的关系。结果并发组和无发组第1天血清PCT、CRP、IL-6水平基本相同,差异无统计学意义(P>0.05),并发组第2、3天血清PCT、CRP、IL-6水平及升高值明显高于无发组,差异有统计学意义(P<0.05);ROC曲线分析结果显示,在评估SAP并发细菌感染的敏感度、特异度、准确度、曲线下面积方面,PCT升高值以0.8μg/L为临界值时分别为86.00%、86.67%、86.36%、0.754,CRP升高值以10.0 mg/L为临界值时分别为82.00%、81.67%、81.82%、0.722,IL-6升高值以20.5 mg/L为临界值时分别为84.00%、85.00%、84.55%、0.736,三者联合时分别为96.00%、95.00%、95.45%、0.907,三者联合时明显高于三者单独时,差异有统计学意义(P<0.05)。结论 SAP患者血清PCT、CRP、IL-6水平变化与其并发细菌感染有关,监测三者水平变化可作为评估患者并发细菌感染的重要指标,且三者联合时具有更佳的评估效能,值得临床作进一步推广。
Objective To investigate the changes of serum levels of procalcitonin(PCT),C reactive protein(CRP),interleukin 6(IL-6)and their relationships with with complicated bacterial infection in patients with severe acute pancreatitis(SAP).Methods A total of 220 patients with SAP who were admitted and treated in our hospital from January 2015 to January 2018 were enrolled in the study,according to whether or not the patients have bacterial infection,these patients were divided into complicated infection group(n=100)and non complicated infection group(n=120).The serum levels of PCT,CRP and IL-6 were detected in both groups.The changes of serum levels of PCT,CRP,IL-6 and their relationships with complicated bacterial infection were observed and compared between the two groups.Results There were no significant differences in the serum levels of PCT,CRP,IL-6 at the first day between complicated infection group and non complicated infection group(P>0.05),however,the serum levels of PCT,CRP,IL-6 at the second day and the third day in complicated infection group were significantly higher than those before treatment(P<0.05),moreover the increase degree of the serum levels of PCT,CRP,IL-6 in complicated infection group was more significant than that in non complicated infection group(P<0.05).The ROC curve analysis result showed that in the evaluation of patients complicated bacterial infection,the sensitivity,specificity,accuracy,and the area under the curve were 86.00%,86.67%,86.36%,0.754,respectively.Taking the PCT rising value of 0.8μg/L as critical value,the sensitivity,specificity,accuracy,and the area under the curve were 86.00%,86.67%,86.36%,0.754,respectively,taking CRP rising value of 10.0 mg/L as critical value,the sensitivity,specificity,accuracy,and the area under the curve were 82.00%,81.67%,81.82%,0.722,respectively,taking IL-6 rising value of 20.5 mg/L as critical value,the sensitivity,specificity,accuracy and the area under the curve were were 84.00%,85%,84.55%,0.736 respectively.Moreover when combination detection of the three indexes,the sensitivity,specificity,accuracy and the area under the curve were 96%,95%,95.45%,0.907,respectively,which were significantly higher than those by simple detection of the three indexes(P<0.05).Conclusion The changes of serum levels of PCT,CRP,IL-6 in patients with SAP are related to the bacterial infection,which can be monitored as the important indicators of patients with SAP complicated by bacterial infection.And the combination of the three indexes has better evaluation efficacy,which is worthy of further clinical promotion.
作者
周小娜
杨永林
ZHOU Xiaona;YANG Yonglin(Department of Digestive System Diseases,The First Affiliated Hospital of Dali University,Yun’nan,Dali 671000,China)
出处
《河北医药》
CAS
2019年第6期839-842,共4页
Hebei Medical Journal
基金
云南省科技厅(编号:2010ZC147)
作者简介
通讯作者:杨永林,E-mail:yyl4320@163.com
