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
目的:比较联合胰腺外炎症CT评分(extropancreatic inflammation on abdominal computed tomography,EPIC)及中性粒细胞与淋巴细胞比值(neutropil-lymphocyte rate,NLR)与急性胰腺炎床旁严重指数(bedside index for severity in acute pa...目的:比较联合胰腺外炎症CT评分(extropancreatic inflammation on abdominal computed tomography,EPIC)及中性粒细胞与淋巴细胞比值(neutropil-lymphocyte rate,NLR)与急性胰腺炎床旁严重指数(bedside index for severity in acute pancreatitis,BISAP)早期预测急性胰腺炎(acute pancreatitis,AP)严重性的价值.方法:对2010-01/2014-04住院的358例AP患者资料进行分析.对所有患者进行EPIC、NLR、BISAP、改良Marshall及联合指标评分.联合指标评分为EPIC分数加上NLR得分(其中NLR≥7.345为1分,<7.345为0分).轻度AP划入轻症组,中度AP重度AP划入重症组.两组的EPIC、NLR、BISAP及联合指标评分进行t检验,采用Spearman检验评价各类指标评分与重症的相关性.对各类指标早期预测AP严重性的曲线下面积(area under curve,AUC)及敏感性、特殊性、准确性、阳性预测值、阴性预测值、约登指数进行了研究.结果:358例AP中,重症55例(占15.363%,55/358),轻症303例(占84.637%,303/358).重症组的EPIC、NLR、BISAP及联合指标评分比轻症组的评分高,分别为4.200±1.393 vs 1.373±1.333,14.358±5.908 vs 7.929±4.514,2.655±0.985 vs 0.993±0.843,5.164±1.385 vs 1.819±1.493,所有P=0.000.EPIC、NLR、BISAP及联合指标评分与重症的相关系数分别为0.529、0.406、0.546及0.554,所有P=0.000.EPIC、NLR、BISAP及联合指标评分早期预测AP严重性的AUC分别为0.914(95%CI:0.867-0.961),0.825(95%CI:0.778-0.872),0.911(95%CI:0.863-0.960)及0.938(95%CI:0.900-0.975),所有P=0.000.BISAP及联合指标评分预测重症的敏感性、特异性、准确性、阳性预测值、阴性预测值及约登指数分别为90.909%、80.528%、82.123%、45.872%、97.992%、0.714及85.455%、86.469%、86.313%、53.409%、97.037%、0.719.结论:联合EPIC及NLR指标简便易于获得,其早期预测AP严重性的曲线下面积较BISAP的预测面积大,与其他指标相比,其预测的重症AP的特异性及准确性较高.展开更多
目的:通过与Ranson评分、BISAP评分比较,探讨乳酸脱氢酶(LDH)联合BISAP评分对急性胰腺炎(AP)预后的预测价值。方法:回顾分析我院收治的200例AP患者的资料,包括48 h Ranson评分、24 h BISAP评分及24 h内血清LDH值。对BISAP评分及LDH两个...目的:通过与Ranson评分、BISAP评分比较,探讨乳酸脱氢酶(LDH)联合BISAP评分对急性胰腺炎(AP)预后的预测价值。方法:回顾分析我院收治的200例AP患者的资料,包括48 h Ranson评分、24 h BISAP评分及24 h内血清LDH值。对BISAP评分及LDH两个变量进行二分类Logistic回归分析,应用ROC曲线下面积(AUC)检验3项数据对AP持续器官损害的预测价值。结果:Ranson评分、BISAP评分及LDH联合BISAP评分3项数据预测持续器官损害的AUC分别为0.931、0.903及0.928。其中LDH联合BISAP评分与Ranson评分比较差异无统计学意义(P=0.926),与BISAP评分比较差异有统计学意义(P=0.035)。结论:LDH联合BISAP评分对AP发生持续器官损害的预测能力明显优于BISAP评分,较Ranson评分无明显差异且比其更简便、及时、经济,临床应用价值大。展开更多
目的比较BISAP评分与Ranson评分在预测急性胰腺炎(acute pancreatitis,AP)的严重程度、死亡结局方面的应用价值。方法运用BISAP(bedside index for severity in AP)评分与Ranson评分对124例AP患者进行回顾性评分,比较轻症组与重症组、...目的比较BISAP评分与Ranson评分在预测急性胰腺炎(acute pancreatitis,AP)的严重程度、死亡结局方面的应用价值。方法运用BISAP(bedside index for severity in AP)评分与Ranson评分对124例AP患者进行回顾性评分,比较轻症组与重症组、死亡组与存活组的评分差异,比较高分组与低分组之间重症急性胰腺炎(SAP)发生率、病死率的差异。结果重症组与轻症组、死亡组与存活组的BISAP及Ranson评分差异均有统计学意义(P<0.01)。对于Ranson高分组(≥3分)和低分组(<3分)患者SAP发生率间差异有统计学意义(P<0.01),两组病死率差异无统计学意义(P>0.05)。对于BISAP高分组(≥3分)与低分组(<3分)的SAP及病死率间差异均有统计学意义(P<0.01)。结论 BISAP评分与Ranson评分对于判断AP严重程度均具有重要参考意义。BISAP简便易行,能够早期对AP患者进行死亡风险评估。展开更多
目的探讨血清可溶性协同刺激分子B7家族4(soluble costimulatory molecules B7 Homolog 2,B7-H4)联合急性胰腺炎严重度床旁指数(bedside index for severity in acute pancreatitis,BISAP)评分评估急性胰腺炎(acute pancreatitis,AP)患...目的探讨血清可溶性协同刺激分子B7家族4(soluble costimulatory molecules B7 Homolog 2,B7-H4)联合急性胰腺炎严重度床旁指数(bedside index for severity in acute pancreatitis,BISAP)评分评估急性胰腺炎(acute pancreatitis,AP)患者病情及疾病转归的临床价值。方法选取2019年10月至2022年7月黄河科技学院附属医院收治的AP患者228例,根据病情严重程度,分为轻症急性胰腺炎(mild acute pancreatitis,MAP)组(117例)与重症急性胰腺炎(severe acute pancreatitis,SAP)组(111例),所有患者入院24h采集静脉血,检测一般临床指标及B7-H4水平,并进行BISAP测评,分析各指标的相关性,采用ROC曲线分析B7-H4、BISAP评分单独及联合应用预测SAP及患者死亡的效能。结果SAP组总胆固醇(5.24±0.74)mmol/L、甘油三酯(5.61±0.56)mmol/L、低密度脂蛋白胆固醇(2.78±0.89)mmol/L、白细胞计数(14.95±2.22)×10^(9)/L、血清淀粉酶(566.93±86.36)U/L、血清脂肪酶(687.18±104.77)U/L、BISAP评分(1.94±0.89)分高于MAP组[(4.77±0.65)mmol/L、(4.49±0.63)mmol/L、(2.31±0.45)mmol/L、(11.73±2.51)×10^(9)/L、(471.20±67.29)U/L、(504.68±98.64)U/L、(1.33±0.78)分)],高密度脂蛋白胆固醇(0.56±0.35)mmol/L低于MAP组(0.84±0.24)mmol/L(P<0.05);相关分析显示,白细胞计数、血清淀粉酶、脂肪酶、B7-H4、BISAP评分两两之间均呈正相关(r=0.426、0.514、0.742、0.535、0.673、0.757、0.556、0.664、0.673、0.578,P<0.05);ROC分析显示,B7-H4联合BISAP评分预测SAP、患者死亡的AUC值(0.936、0.857)、敏感性(0.894、0.866)、特异性(0.827、0.819)均高于单独应用B7-H4或BISAP评分(P<0.05)。结论B7-H4联合BISAP评分在评估AP患者病情严重程度及预后的效能优于单独采用B7-H4或BISAP评分,具有较佳的临床应用价值。展开更多
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。
文摘目的:比较联合胰腺外炎症CT评分(extropancreatic inflammation on abdominal computed tomography,EPIC)及中性粒细胞与淋巴细胞比值(neutropil-lymphocyte rate,NLR)与急性胰腺炎床旁严重指数(bedside index for severity in acute pancreatitis,BISAP)早期预测急性胰腺炎(acute pancreatitis,AP)严重性的价值.方法:对2010-01/2014-04住院的358例AP患者资料进行分析.对所有患者进行EPIC、NLR、BISAP、改良Marshall及联合指标评分.联合指标评分为EPIC分数加上NLR得分(其中NLR≥7.345为1分,<7.345为0分).轻度AP划入轻症组,中度AP重度AP划入重症组.两组的EPIC、NLR、BISAP及联合指标评分进行t检验,采用Spearman检验评价各类指标评分与重症的相关性.对各类指标早期预测AP严重性的曲线下面积(area under curve,AUC)及敏感性、特殊性、准确性、阳性预测值、阴性预测值、约登指数进行了研究.结果:358例AP中,重症55例(占15.363%,55/358),轻症303例(占84.637%,303/358).重症组的EPIC、NLR、BISAP及联合指标评分比轻症组的评分高,分别为4.200±1.393 vs 1.373±1.333,14.358±5.908 vs 7.929±4.514,2.655±0.985 vs 0.993±0.843,5.164±1.385 vs 1.819±1.493,所有P=0.000.EPIC、NLR、BISAP及联合指标评分与重症的相关系数分别为0.529、0.406、0.546及0.554,所有P=0.000.EPIC、NLR、BISAP及联合指标评分早期预测AP严重性的AUC分别为0.914(95%CI:0.867-0.961),0.825(95%CI:0.778-0.872),0.911(95%CI:0.863-0.960)及0.938(95%CI:0.900-0.975),所有P=0.000.BISAP及联合指标评分预测重症的敏感性、特异性、准确性、阳性预测值、阴性预测值及约登指数分别为90.909%、80.528%、82.123%、45.872%、97.992%、0.714及85.455%、86.469%、86.313%、53.409%、97.037%、0.719.结论:联合EPIC及NLR指标简便易于获得,其早期预测AP严重性的曲线下面积较BISAP的预测面积大,与其他指标相比,其预测的重症AP的特异性及准确性较高.
文摘目的:通过与Ranson评分、BISAP评分比较,探讨乳酸脱氢酶(LDH)联合BISAP评分对急性胰腺炎(AP)预后的预测价值。方法:回顾分析我院收治的200例AP患者的资料,包括48 h Ranson评分、24 h BISAP评分及24 h内血清LDH值。对BISAP评分及LDH两个变量进行二分类Logistic回归分析,应用ROC曲线下面积(AUC)检验3项数据对AP持续器官损害的预测价值。结果:Ranson评分、BISAP评分及LDH联合BISAP评分3项数据预测持续器官损害的AUC分别为0.931、0.903及0.928。其中LDH联合BISAP评分与Ranson评分比较差异无统计学意义(P=0.926),与BISAP评分比较差异有统计学意义(P=0.035)。结论:LDH联合BISAP评分对AP发生持续器官损害的预测能力明显优于BISAP评分,较Ranson评分无明显差异且比其更简便、及时、经济,临床应用价值大。
文摘目的比较BISAP评分与Ranson评分在预测急性胰腺炎(acute pancreatitis,AP)的严重程度、死亡结局方面的应用价值。方法运用BISAP(bedside index for severity in AP)评分与Ranson评分对124例AP患者进行回顾性评分,比较轻症组与重症组、死亡组与存活组的评分差异,比较高分组与低分组之间重症急性胰腺炎(SAP)发生率、病死率的差异。结果重症组与轻症组、死亡组与存活组的BISAP及Ranson评分差异均有统计学意义(P<0.01)。对于Ranson高分组(≥3分)和低分组(<3分)患者SAP发生率间差异有统计学意义(P<0.01),两组病死率差异无统计学意义(P>0.05)。对于BISAP高分组(≥3分)与低分组(<3分)的SAP及病死率间差异均有统计学意义(P<0.01)。结论 BISAP评分与Ranson评分对于判断AP严重程度均具有重要参考意义。BISAP简便易行,能够早期对AP患者进行死亡风险评估。
