Predictive Value of Serum Cholinesterase Levels Combined with Inflammatory Response Factors for Pulmonary Infection Complicating Severe Acute Pancreatitis
FAN Bin, LI QingHe, LI Wei, et al
Enshi Tujia and Miao Autonomous Prefecture Central Hospital, Hubei Enshi 445000, China
Abstract：Objective: To explore the predictive value of serum cholinesterase (ChE), C-reactive protein (CRP), and interleukin-6 (IL-6) for pulmonary infection (PI) in patients with severe acute pancreatitis (SAP).Methods: Eighty SAP patients treated at our hospital from January 2018 to January 2024 were selected as the SAP group. Based on whether these patients developed PI, they were divided into the PI group (40 cases) and the non-PI group (40 cases). According to clinical PI scores, the subjects were categorized into mild, moderate, and severe groups, and 60 healthy individuals were selected as controls. Serum ChE, CRP, and IL-6 levels were measured using ELISA. The pulmonary ventilation function index (mechanical ventilation time (days)) was compared among groups. Logistic regression analysis was used to identify risk factors for PI in SAP patients. The predictive value of serum ChE, CRP, and IL-6 for PI in SAP was assessed using ROC curves.Results: Compared with the control group, the SAP group had significantly lower serum ChE levels and significantly higher CRP and IL-6 levels (P<0.05). Among patients with different PI scores, serum ChE levels showed a pattern of mild > moderate > severe, whereas CRP and IL-6 levels exhibited the opposite trend, with statistically significant differences (P<0.05). The PI group had significantly higher CRP and IL-6 levels and significantly lower serum ChE levels than the non-PI group (P<0.05). The mechanical ventilation time was shorter in the PI group compared to the non-PI group (P<0.05). Logistic regression analysis revealed that increased CRP and IL-6 levels and low serum ChE were independently associated with poor prognosis in SAP patients with PI (P<0.05), with an AUC of 0.807, which was greater than the AUC values of serum ChE, CRP, and IL-6 alone (0.716, 0.749, and 0.732, respectively), all statistically significant (P<0.05). Combined detection had a sensitivity of 87.5% and a specificity of 67.5% for predicting PI in SAP patients.Conclusion: In patients with SAP complicated by PI, decreased serum ChE levels and increased CRP and IL-6 levels are independent risk factors for the occurrence of PI. Combined detection of these three markers has high predictive value for the occurrence of PI in SAP patients.
樊斌, 李庆贺, 李伟, 张家耀. 血清胆碱酯酶水平联合炎性反应因子对重症急性胰腺炎并发肺部感染的预测价值[J]. 河北医学, 2024, 30(6): 1003-1007.
FAN Bin, LI QingHe, LI Wei, et al. Predictive Value of Serum Cholinesterase Levels Combined with Inflammatory Response Factors for Pulmonary Infection Complicating Severe Acute Pancreatitis. HeBei Med, 2024, 30(6): 1003-1007.
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2024, Vol. 30 
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