目的:探讨全身免疫炎症指数(Systemic Immune Inflammation Index,SII)与急性重症胰腺炎(Acute Severe Pancreatitis,SAP)的相关性,并评估SII联合急性胰腺炎严重程度床边指数(Bedside Index for Severity in Acute Pancreatitis,BISAP)...目的:探讨全身免疫炎症指数(Systemic Immune Inflammation Index,SII)与急性重症胰腺炎(Acute Severe Pancreatitis,SAP)的相关性,并评估SII联合急性胰腺炎严重程度床边指数(Bedside Index for Severity in Acute Pancreatitis,BISAP)对SAP的早期预测价值。方法:选取149名急性胰腺炎(Acute Pancreatitis,AP)患者,根据病情严重程度分为SAP组和非SAP组,比较2组患者SII和BISAP评分,分析各项实验室指标对SAP的早期预测价值。结果:SAP组患者SII、BISAP评分均高于非SAP组(P<0.05)。ROC曲线展示SII、BISAP评分及两者联合预测SAP的曲线下面积(AUC)分别为0.818(95%CI:0.747~0.890),0.878(95%CI:0.821~0.935)和0.923(95%CI:0.879~0.967)。结论:SII结合BISAP评分对SAP的早期预测有着一定的临床价值。展开更多
Objective:To investigate the value of dynamic monitoring of serum interleukin(IL)-33 and tumor necrosis factor(TNF)-αlevels in the early diagnosis,severity assessment and prognosis of acute pancreatitis(AP)combined w...Objective:To investigate the value of dynamic monitoring of serum interleukin(IL)-33 and tumor necrosis factor(TNF)-αlevels in the early diagnosis,severity assessment and prognosis of acute pancreatitis(AP)combined with abdominal CT radiomics and intestinal microbiota data.Methods:A total of 170 AP patients were admitted immediately after the onset of the disease and divided into MAP group(85 cases)and SAP group(85 cases).The levels of serum IL-33,TNF-α,IL-6,and HMGB1,as well as the expression of miRNA-155 in extracellular vesicles(EVs),were dynamically monitored at multiple time points(0 h,6 h,12 h,24 h,3 d,5 d,7 d,14 d)after admission.Abdominal CT radiomics analyzed the texture characteristics of pancreatic necrosis,and stool samples collected at admission were metagenomic sequencing of the gut microbiome.The Acute Pancreatitis Severity Bedside Index(BISAP)score is calculated within 48 hours of admission.Multivariate regression analysis assessed the independent effects of various factors on the prognosis of mortality groups.Results:Serum IL-33 and TNF-αlevels in SAP patients were significantly higher than those in MAP patients(p<0.05)at all time points,peaked on day 3,and decreased with treatment.The levels of these cytokines in patients with SIRS were also higher than in patients without SIRS(p<0.05).The serum IL-33,TNF-αlevels and BISAP scores in the mortality group were higher than those in the survival group(p<0.05).Multivariate regression analysis showed that serum IL-33(OR=3.21,95%CI:1.12–9.23,p=0.03),TNF-α(OR=4.05,95%CI:1.37–11.96,p=0.01),and BISAP score(OR=5.67,95%CI:1.83–17.54,p<0.01)were independent prognostic risk factors.Spearman correlation analysis showed that serum IL-33 and TNF-αlevels were positively correlated with BISAP scores(r=0.68,p<0.01;r=0.73,p<0.01).Conclusion:Dynamic monitoring of serum IL-33 and TNF-αlevels combined with BISAP score has important clinical value for early diagnosis,severity assessment,treatment guidance and prognosis evaluation of AP,and provides a basis for accurate diagnosis and treatment.展开更多
目的探讨CT评估的脂肪肝、中性粒细胞淋巴细胞比值(neutrophil to lymphocyte ratio,NLR)及急性胰腺炎床旁严重度指数(BISAP)建立的预测模型在发病24小时内对高脂血症性急性胰腺炎(HTGP)重症化倾向的预测价值。方法回顾性分析2015年1月...目的探讨CT评估的脂肪肝、中性粒细胞淋巴细胞比值(neutrophil to lymphocyte ratio,NLR)及急性胰腺炎床旁严重度指数(BISAP)建立的预测模型在发病24小时内对高脂血症性急性胰腺炎(HTGP)重症化倾向的预测价值。方法回顾性分析2015年1月至2023年6月在发病24小时内就诊于民航总医院的339例HTGP患者的临床资料,并分为重症急性胰腺炎组(SAP组)、中度重症急性胰腺炎组(MSAP组)及轻症急性胰腺炎组(MAP组),MSAP+SAP组为NMAP组。比较三组患者的基本资料、血常规(白细胞计数、中性粒细胞计数、NLR、血小板计数、红细胞比容)、肝/脾CT值、MCTSI评分、BISAP评分等。对血常规结果、肝/脾CT值及评分系统进行单因素分析,然后将有统计学意义的结果进行多因素Logistic回归分析并建立预测模型。采用受试者工作特征曲线下面积分析各指标对NMAP的预测效能。结果各组间白细胞计数、中性粒细胞计数、NLR、肝/脾CT值、MCTSI评分、BISAP评分的差异有统计学意义(P<0.05)。单因素分析显示白细胞计数、中性粒细胞计数、NLR、血小板计数、肝/脾CT值、MCTSI评分、BISAP评分是患者发生NMAP的影响因素(P<0.05)。多因素分析显示BISAP评分、NLR、肝/脾CT值是HTGP严重程度的独立预测因素(P值均<0.05),建立NMAP的预测模型:-5.244-3.459肝/脾CT值+5.672BISAP评分+0.518NLR,模型能正确分类95%的研究对象,敏感度为94.9%,特异度为95.2%,阳性预测值为97.8%,阴性预测值为89.2%,Hosmer-Lemeshow检验显示该预测模型差异无统计学意义(P值>0.05)。Logistic回归模型预测NMAP的AUC值(0.988)、敏感度(91.49%)、特异度(100.00%)均高于其它指标。结论联合CT评估的脂肪肝、NLR及BISAP评分建立的预测模型在发病24小时内即对高脂血症性急性胰腺炎的重症化倾向有非常好的预测价值。展开更多
文摘目的:探讨全身免疫炎症指数(Systemic Immune Inflammation Index,SII)与急性重症胰腺炎(Acute Severe Pancreatitis,SAP)的相关性,并评估SII联合急性胰腺炎严重程度床边指数(Bedside Index for Severity in Acute Pancreatitis,BISAP)对SAP的早期预测价值。方法:选取149名急性胰腺炎(Acute Pancreatitis,AP)患者,根据病情严重程度分为SAP组和非SAP组,比较2组患者SII和BISAP评分,分析各项实验室指标对SAP的早期预测价值。结果:SAP组患者SII、BISAP评分均高于非SAP组(P<0.05)。ROC曲线展示SII、BISAP评分及两者联合预测SAP的曲线下面积(AUC)分别为0.818(95%CI:0.747~0.890),0.878(95%CI:0.821~0.935)和0.923(95%CI:0.879~0.967)。结论:SII结合BISAP评分对SAP的早期预测有着一定的临床价值。
文摘Objective:To investigate the value of dynamic monitoring of serum interleukin(IL)-33 and tumor necrosis factor(TNF)-αlevels in the early diagnosis,severity assessment and prognosis of acute pancreatitis(AP)combined with abdominal CT radiomics and intestinal microbiota data.Methods:A total of 170 AP patients were admitted immediately after the onset of the disease and divided into MAP group(85 cases)and SAP group(85 cases).The levels of serum IL-33,TNF-α,IL-6,and HMGB1,as well as the expression of miRNA-155 in extracellular vesicles(EVs),were dynamically monitored at multiple time points(0 h,6 h,12 h,24 h,3 d,5 d,7 d,14 d)after admission.Abdominal CT radiomics analyzed the texture characteristics of pancreatic necrosis,and stool samples collected at admission were metagenomic sequencing of the gut microbiome.The Acute Pancreatitis Severity Bedside Index(BISAP)score is calculated within 48 hours of admission.Multivariate regression analysis assessed the independent effects of various factors on the prognosis of mortality groups.Results:Serum IL-33 and TNF-αlevels in SAP patients were significantly higher than those in MAP patients(p<0.05)at all time points,peaked on day 3,and decreased with treatment.The levels of these cytokines in patients with SIRS were also higher than in patients without SIRS(p<0.05).The serum IL-33,TNF-αlevels and BISAP scores in the mortality group were higher than those in the survival group(p<0.05).Multivariate regression analysis showed that serum IL-33(OR=3.21,95%CI:1.12–9.23,p=0.03),TNF-α(OR=4.05,95%CI:1.37–11.96,p=0.01),and BISAP score(OR=5.67,95%CI:1.83–17.54,p<0.01)were independent prognostic risk factors.Spearman correlation analysis showed that serum IL-33 and TNF-αlevels were positively correlated with BISAP scores(r=0.68,p<0.01;r=0.73,p<0.01).Conclusion:Dynamic monitoring of serum IL-33 and TNF-αlevels combined with BISAP score has important clinical value for early diagnosis,severity assessment,treatment guidance and prognosis evaluation of AP,and provides a basis for accurate diagnosis and treatment.
文摘目的探讨CT评估的脂肪肝、中性粒细胞淋巴细胞比值(neutrophil to lymphocyte ratio,NLR)及急性胰腺炎床旁严重度指数(BISAP)建立的预测模型在发病24小时内对高脂血症性急性胰腺炎(HTGP)重症化倾向的预测价值。方法回顾性分析2015年1月至2023年6月在发病24小时内就诊于民航总医院的339例HTGP患者的临床资料,并分为重症急性胰腺炎组(SAP组)、中度重症急性胰腺炎组(MSAP组)及轻症急性胰腺炎组(MAP组),MSAP+SAP组为NMAP组。比较三组患者的基本资料、血常规(白细胞计数、中性粒细胞计数、NLR、血小板计数、红细胞比容)、肝/脾CT值、MCTSI评分、BISAP评分等。对血常规结果、肝/脾CT值及评分系统进行单因素分析,然后将有统计学意义的结果进行多因素Logistic回归分析并建立预测模型。采用受试者工作特征曲线下面积分析各指标对NMAP的预测效能。结果各组间白细胞计数、中性粒细胞计数、NLR、肝/脾CT值、MCTSI评分、BISAP评分的差异有统计学意义(P<0.05)。单因素分析显示白细胞计数、中性粒细胞计数、NLR、血小板计数、肝/脾CT值、MCTSI评分、BISAP评分是患者发生NMAP的影响因素(P<0.05)。多因素分析显示BISAP评分、NLR、肝/脾CT值是HTGP严重程度的独立预测因素(P值均<0.05),建立NMAP的预测模型:-5.244-3.459肝/脾CT值+5.672BISAP评分+0.518NLR,模型能正确分类95%的研究对象,敏感度为94.9%,特异度为95.2%,阳性预测值为97.8%,阴性预测值为89.2%,Hosmer-Lemeshow检验显示该预测模型差异无统计学意义(P值>0.05)。Logistic回归模型预测NMAP的AUC值(0.988)、敏感度(91.49%)、特异度(100.00%)均高于其它指标。结论联合CT评估的脂肪肝、NLR及BISAP评分建立的预测模型在发病24小时内即对高脂血症性急性胰腺炎的重症化倾向有非常好的预测价值。
