摘要
目的 探究老年急性胆源性胰腺炎(acute biliary pancreatitis, ABP)患者血清炎症因子水平与临床结局的相关性。方法 回顾性研究2020年4月—2022年4月在安徽医科大学第二附属医院急诊外科就诊的112例老年ABP患者的临床资料。所有患者均行ERCP手术治疗,根据患者临床结局划分为死亡组(n=32)与存活组(n=83)。对比组间患者的谷草转氨酶(AST)、谷丙转氨酶(ALT)、碱性磷酸酶(ALP)、血清白蛋白(ALB)、血清淀粉酶(AMS)、乳酸脱氢酶(LDH)、尿素氮(BUN)、肌酐(Cr)、白细胞计数(WBC)、红细胞比容(Hct)、粒细胞与淋巴细胞比值(NLR)、肿瘤坏死因子-α(TNF-α)、 C反应蛋白(CRP)、降钙素原(PCT)、白细胞介素6(IL-6)和白细胞介素8 (IL-8)水平,并通过相关性分析及二元Logistic回归寻找与ABP患者死亡相关的危险因素。结果 2组患者基础临床资料差异均无统计学意义(P>0.05)。临床检测指标中死亡组ALT、 AMS及Hct水平明显高于存活组(P<0.05),其余肝肾功能和血常规指标值在2组间的差异无统计学意义(P>0.05)。死亡组CRP、 PCT、 IL-6及IL-8水平显著高于存活组(P<0.05), TNF-α水平在2组患者中差异无统计学意义(P>0.05)。Spearman相关性分析表明,ALT、 CRP、 PCT、 IL-6和IL-8水平与患者死亡结局相关(P<0.05)。二元Logistic回归表明,ALT、 CRP、 PCT、 IL-6和IL-8水平升高均是患者死亡的危险因素(P<0.05)。结论 ALT、 CRP、 PCT、 IL-6和IL-8水平升高可能预示ABP患者不良临床结局,在疾病早期或治疗过程中检测相关指标变化可利于判断患者预后、及时调整治疗方案、提高ABP患者生存率。
Objective To explore the relationship between the levels of serum inflammatory factors and clinical out⁃come in elderly patients with acute biliary pancreatitis(ABP).Methods The clinical data of 112 elderly patients with ABP treated in Department of Emergency Surgery of Second Affiliated Hospital of Anhui Medical University from April 2020 to April 2022 were retrospectively studied.All patients were treated with ERCP operation.According to the clinical outcome,they were divided into two groups:death group(n=32)and survival group(n=83).The levels of aspartate aminotransferase(AST),alanine aminotransferase(ALT),alkaline phosphatase(ALP),serum albumin(ALB),serum amylase(AMS),lactate dehy⁃drogenase(LDH),urea nitrogen(BUN),creatinine(Cr),white blood cell count(WBC),hematocrit(Hct),granulocyte to lymphocyte ratio(NLR),tumor necrosis factor⁃α(TNF⁃α),C⁃reactive protein(CRP),procalcitonin(PCT),interleukin 6(IL⁃6),and interleukin 8(IL⁃8)were compared between the two groups.Correlation analysis and binary Logistic regression were used to identify the risk factors associated with death in ABP patients.Results There was no significant difference in bas⁃ic clinical data between the two groups(P>0.05).The levels of ALT,AMS and Hct of the death group were significantly higher than those of the survival group(P<0.05),while the other indexes of liver and kidney function and blood routine were not significantly different between the two groups(P>0.05).The levels of CRP,PCT,IL⁃6 and IL⁃8 of the death group were significantly higher than those of the survival group(P<0.05),but there was no significant difference in TNF⁃αlevel between the two groups(P>0.05).Spearman correlation analysis showed that the levels of ALT,CRP,PCT,IL⁃6 and IL⁃8 were as⁃sociated with death outcome of patients(P<0.05).Binary Logistic regression showed that elevated levels of ALT,CRP,PCT,IL⁃6,and IL⁃8 were risk factors for patient death(P<0.05).Conclusion Elevated levels of ALT,CRP,PCT,IL⁃6,and IL⁃8 may indicate adverse clinical outcomes in ABP patients.At the early stage of the disease or in the course of treatment,detecting changes of these indexes is helpful to judge the prognosis of patients,adjust timely the treatment plan,and improve the survival rate of ABP patients.
作者
汪海平
孙远松
李贺
Wang Haiping;Sun Yuansong;Li He(Department of Emergency Surgery,Second Affiliated Hospital of Anhui Medical University,Hefei,Anhui,230601,P.R.China)
出处
《老年医学与保健》
CAS
2023年第2期346-351,共6页
Geriatrics & Health Care
基金
安徽医科大学校科研基金项目(2020xkj025)。
关键词
老年
急性胆源性胰腺炎
炎症因子
临床结局
elderly
acute biliary pancreatitis
inflammatory factor
clinical outcome
