2023 年第 11 期 第 18 卷

血清白细胞介素6和转化生长因子β1及肠型脂肪酸结合蛋白水平对重症急性胰腺炎并发腹腔间隔室综合征的诊断价值

Diagnostic value of serum interleukin-6, transforming growth factor-β1 and intestinal fatty acid binding protein levels in severe acute pancreatitis complicated with abdominal compartment syndrome

作者：张振崔伟徐帅

英文作者：Zhang Zhen Cui Wei Xu Shuai

单位：内蒙古自治区人民医院急诊医学科，呼和浩特010017

英文单位：Department of Emergency Medicine Inner Mongolia People′s Hospital Hohhot 010017 China

关键词：重症急性胰腺炎；腹腔间隔室综合征；白细胞介素6；转化生长因子β1；肠型脂肪酸结合蛋白

英文关键词：Severeacutepancreatitis;Abdominalcompartmentsyndrome;Interleukin-6;Transforminggrowthfactor-β1;Intestinalfattyacidbindingprotein

• 摘要：

• 目的  探讨血清白细胞介素6（IL-6）和转化生长因子β1（TGF-β1）及肠型脂肪酸结合蛋白（I-FABP）水平对重症急性胰腺炎（SAP）并发腹腔间隔室综合征（ACS）的诊断价值。方法  选取2020年1月至2022年12月内蒙古自治区人民医院收治的89例SAP患者为SAP组，根据是否并发ACS分为ACS组（53例）和非ACS组（36例），另选取本院同期41例体检健康者为对照组。收集SAP患者临床资料，采用酶联免疫吸附试验法检测血清IL-6、TGF-β1、I-FABP水平。采用多因素Logistic回归方法分析SAP并发ACS的影响因素，受试者工作特征曲线分析血清IL-6、TGF-β1、I-FABP水平对SAP并发ACS的诊断价值。结果  SAP组血清IL-6、I-FABP水平均高于对照组，TGF-β1水平低于对照组［26（20,32）ng/L比7（5,9）ng/L、（162±26）μg/L比（100±19）μg/L、（36±8）μg/L比（53±6）μg/L］，差异均有统计学意义（均P＜0.001）。ACS组TGF-β1水平低于非ACS组，IL-6、I-FABP水平均高于非ACS组，差异均有统计学意义（均P＜0.05）。多因素Logistic回归分析结果显示，入住重症监护病房时间延长、急性生理学和慢性健康状况评分系统Ⅱ评分增加和IL-6、I-FABP升高为SAP并发ACS的独立危险因素，TGF-β1升高为独立保护因素（均P＜0.05）。受试者工作特征曲线分析结果显示，血清IL-6、TGF-β1、I-FABP水平联合检测诊断SAP并发ACS的曲线下面积为0.888（95%置信区间：0.804～0.945），大于IL-6、TGF-β1、I-FABP单独检测（P<0.05）。结论  SAP患者血清IL-6、I-FABP水平升高和TGF-β1水平降低与并发ACS有关，血清IL-6、TGF-β1、I-FABP水平联合检测诊断SAP并发ACS的价值较高。

• Objective  To investigate the diagnostic value of serum interleukin-6(IL-6), transforming growth factor-β1(TGF-β1) and intestinal fatty acid binding protein(I-FABP) levels in severe acute pancreatitis (SAP) complicated with abdominal compartment syndrome(ACS). Methods  From January 2020 to December 2022, 89 patients with SAP admitted to Inner Mongolia People′s Hospital were selected as the SAP group, they were divided into the ACS group(53 cases) and the non-ACS group(36 cases) according to whether they had concomitant ACS, and another 41 healthy individuals who underwent physical examination in the same period of the hospital were selected as the control group. Clinical data of patients with SAP were collected, and serum IL-6, TGF-β1 and I-FABP levels were detected by enzyme-linked immunosorbent assay. Multivariate Logistic regression method was used to analyze the influencing factors of SAP complicated with ACS, and receiver operating characteristic curve was used to analyze the diagnostic value of serum IL-6, TGF-β1 and I-FABP levels for SAP complicated ACS. Results  Serum IL-6 and I-FABP levels in the SAP group were higher than those in the control group, and TGF-β1 level was lower than that in the control group［26（20,32）ng/L vs 7（5,9）ng/L, （162±26） g/L vs （100±19） g/L, （36±8） g/L vs （53±6） g/L］(all P＜0.001). Serum TGF-β1 level in the ACS group was lower than that in the non-ACS group, and IL-6 and I-FABP levels were higher than those in the control group (all P<0.05). Multivariate Logistic regression analysis Results   showed that prolonged intensive care unit time, increased acute physiology and chronic health evaluation Ⅱ score and elevated IL-6 and I-FABP were independent risk factors for SAP complicated with ACS, and elevated TGF-β1 was an independent protective factor(all P<0.05). Receiver operating characteristic curve analysis Results   showed that the area under curve of the combined detection of serum IL-6, TGF-β1 and I-FABP levels in the diagnosis of SAP complicated with ACS was 0.888(95% confidence interval: 0.804-0.945), and it was greater than that of the detection of IL-6, TGF-β1 and I-FABP alone(P<0.05). Conclusion  Increased serum IL-6, I-FABP levels and decreased TGF-β1 levels in SAP patients are associated with concomitant ACS, and the combined detection of serum IL-6, TGF-β1 and I-FABP levels in diagnosing SAP complicated with ACS is high value.