血清sPD-L1联合Balthazar CT分级对急性胰腺炎患者后期胰周坏死感染的预测能效

doi:10.3969/j.issn.1006-6233.2021.08.020

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摘要 目的: 探讨血清可溶性程序性死亡受体配体1(sPD-L1)联合Balthazar CT分级对急性胰腺炎(AP)患者后期胰周坏死感染的预测能效。方法: 选取我院2018年1月至2020年2月收治的202例AP患者,根据14 d后是否出现胰周坏死感染分为胰周坏死感染组(n=53)和无胰周坏死感染组(n=149)。收集两组患者一般资料,多因素Logistics回归分析AP患者后期胰周坏死感染影响因素,ROC曲线分析血清sPD-L1和Balthazar CT分级对AP患者后期胰周坏死感染的预测价值。结果: 单因素分析显示,C反应蛋白(CRP)、降钙素原(PCT)、绝对淋巴细胞计数(ALC)、急性生理和慢性健康评估Ⅱ(APACHE Ⅱ)评分、sPD-L1、Balthazar CT分级为AP患者后期胰周坏死感染影响因素(P<0.05);多因素Logistics回归分析显示,APACHEⅡ评分、sPD-L1、Balthazar CT分级为AP患者后期胰周坏死感染独立危险因素(P<0.05);sPD-L1联合Balthazar CT分级预测AP患者后期胰周坏死感染的曲线下面积(AUC)为0.878,高于sPD-L1(AUC=0.818)、Balthazar CT分级(AUC=0.744)单独检测(P<0.05)。结论: 血清sPD-L1水平和Balthazar CT分级为AP患者后期胰周坏死感染独立危险因素,sPD-L1联合Balthazar CT分级可提升AP患者后期胰周坏死感染预测价值。

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关键词 ：急性胰腺炎, 胰周坏死感染, 可溶性程序性死亡受体配体1, Balthazar CT分级

Abstract：Objective: To investigate the predictive energy efficiency of serum soluble programmed death ligand 1 (sPD-L1) combined with Balthazar CT grading in patients with acute pancreatitis (AP) in the later\ stage of peripancreatic necrosis infection. Methods: 202 cases of AP patients admitted to our hospital from January 2018 to February 2020 were selected and were divided into peripancreatic necrosis and infection group (n = 53) and non peripancreatic necrosis and infection group (n = 149) according to whether there was peripancreatic necrosis and infection after 14 days. General data of the two groups of patients were collected. Multivariate Logistics regression was used to analyze the influencing factors of late peripancreatic necrosis infection in AP patients. The ROC curve was used to analyze the predictive value of sPD-L1 and Balthazar CT grading for the later period of peripancreatic necrosis infection in AP patients. Results: Univariate analysis showed that C-reactive protein (CRP), procalcitonin (PCT), absolute lymphocyte count (ALC), acute physiology and chronic health assessment Ⅱ (APACHE Ⅱ) score, sPD-L1, and Balthazar CT classification were Influencing factors of peripancreatic necrosis infection in AP patients (P<0.05); Multivariate logistic regression analysis showed that APACHE Ⅱ score , sPD-L1 , Balthazar CT grade were independent risk factors for peripancreatic necrosis infection in AP patients (P<0.05); The area under the curve (AUC) of sPD-L1 combined with Balthazar CT classification was 0.878, which was higher than that of sPD-L1 (AUC=0.818), Balthazar CT classification (AUC=0.744) alone(P<0.05). Conclusion: The increase of serum sPD-L1 level and Balthazar CT grading are independent risk factors for later peripancreatic necrosis infection in AP patients. SPD-L1 combined with Balthazar CT grading can improve the predictive value of later peripancreatic necrosis infection in AP patients.

Key words： Acute pancreatitis Peripancreatic necrosis infection Soluble programmed death ligand 1 Balthazar CT classification

基金资助:陕西省科学技术研究发展计划项目,(编号:2017K16-02-79)

通讯作者: 谭辉

引用本文:

张怡, 谭辉, 刘宁, 董浩, 伏晓琳, 刘博, 李康. 血清sPD-L1联合Balthazar CT分级对急性胰腺炎患者后期胰周坏死感染的预测能效[J]. 河北医学, 2021, 27(8): 1325-1329.
ZHANG Yi, TAN Hui. Predictive Energy Efficiency of Serum SPD-L1 Combined with Balthazar CT Grading in Patients with Acute Pancreatitis in the Late Stage of Peripancreatic Necrosis Infection. HeBei Med, 2021, 27(8): 1325-1329.

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http://www.hbyxzzs.cn/CN/10.3969/j.issn.1006-6233.2021.08.020 或 http://www.hbyxzzs.cn/CN/Y2021/V27/I8/1325

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