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目的:探讨白细胞介素-6(IL-6)、白细胞介素-10(IL-10)联合急性胰腺炎严重程度床边指数(BISAP)评分在重症急性胰腺炎(SAP)预后评估中的作用。方法:回顾性分析2013年5月至2016年5月我院收治的131例SAP患者的临床病历资料,患者入院后24h内采用酶联免疫吸附法(ELISA)检测血清IL-6和IL-10水平,并进行BISAP评分,同时以接近IL-6、IL-10、BISAP评分中位数的自然值为界值,比较不同预后(死亡、感染、多器官功能障碍综合征(MODS)、局部并发症)的发生率。结果:死亡、MODS、感染患者血清IL-6水平、BISAP评分高于局部并发症患者,血清IL-10水平低于局部并发症患者(P<0.05);死亡、MODS患者血清IL-6水平、BISAP评分高于感染患者,血清IL-10水平低于感染患者(P<0.05);死亡患者血清IL-6水平、BISAP评分高于MODS患者,血清IL-10水平低于MODS患者,差异有统计学意义(P<0.05)。IL-6≥65μg/L、IL-10<40μg/L、BISAP评分≥3分患者死亡、MODS、感染发生率更高,差异有统计学意义(P<0.05)。经Pearson积矩相关分析,IL-6、BISAP评分之间呈正相关关系(r=0.617,P<0.05),IL-6、BISAP评分与IL-10之间呈负相关关系(r=-0.572、-0.611,P<0.05)。结论:IL-6、IL-10、BISAP评分是评估SAP预后的重要指标,IL-6水平、BISAP评分越高、IL-10水平越低,患者预后越差,联合应用的预测价值高,临床可作为参考。
Objective: To investigate the role of interleukin-6 (IL-6), interleukin-10 (IL-10) and bedside index of severity of acute pancreatitis (BISAP) in assessing the prognosis of severe acute pancreatitis . Methods: The clinical records of 131 SAP patients admitted to our hospital from May 2013 to May 2016 were retrospectively analyzed. The serum IL-6 and IL-10 levels were detected by enzyme-linked immunosorbent assay (ELISA) Level and BISAP score. At the same time, we compared the different prognosis (death, infection, multiple organ dysfunction syndrome (MODS), local complications with the natural values close to the median of IL-6, IL- Disease) incidence. Results: Serum IL-6 levels in patients with death, MODS and infection were higher than those in patients with local complications, serum IL-10 levels were lower than those with local complications (P <0.05) BISAP score was higher than that of infected patients, serum IL-10 level was lower than that of infected patients (P <0.05); serum IL-6 level and BISAP score of death patients were higher than those of MODS patients, serum IL-10 level was lower than that of MODS patients Significance (P <0.05). Patients with IL-6≥65μg / L, IL-10 <40μg / L and BISAP≥3 had a higher incidence of MODS and infection, with a statistically significant difference (P <0.05). There was a positive correlation between IL-6 and BISAP score (r = 0.617, P <0.05) by Pearson product moment correlation analysis. There was a negative correlation between IL-6 and BISAP score and IL-10 (r = -0.572, -0.611, P <0.05). Conclusion: The IL-6, IL-10 and BISAP scores are important indexes to evaluate the prognosis of SAP. The higher the level of IL-6 and BISAP, the lower the level of IL-10, the worse the prognosis and the higher predictive value of combination. Can be used as a reference.