白介素-6联合红细胞分布宽度血管外肺水指数对重症急性胰腺炎并发急性呼吸窘迫综合征的预测价值

doi:10.3969/j.issn.1006-6233.2023.08.014

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摘要 目的: 探讨血清白介素-6(IL-6)联合红细胞分布宽度(RDW)、血管外肺水指数(ELWI)对重症急性胰腺炎(SAP)并发急性呼吸窘迫综合征(ARDS)的预测价值。方法: 选取2017年1月至2022年7月我院收治的134例SAP患者,根据是否并发ARDS分为ARDS组48例和非ARDS组86例。检测血清IL-6、RDW和监测EVLWI。采用多因素Logistic回归分析SAP并发ARDS的影响因素,采用ROC曲线分析血清IL-6、RDW水平和ELWI对SAP并发ARDS的预测价值。结果: 与非ARDS组比较,ARDS组血清IL-6、RDW水平和ELWI升高(P<0.05)。多因素Logistic回归分析显示,呼吸频率增加(OR=1.042,95%CI:1.002~1.083)和IL-6(OR=1.012,95%CI:1.004~1.019)、RDW(OR=2.225,95%CI:1.339~3.696)、ELWI(OR=1.482,95%CI:1.193~1.840)升高为SAP并发ARDS的独立危险因素,氧合指数升高(OR=0.990,95%CI:0.983~0.996)为独立保护因素(P<0.05)。ROC曲线分析显示,血清IL-6、RDW联合ELWI(AUC=0.889,95%CI:0.824~0.937)预测SAP并发ARDS的曲线下面积(AUC)大于IL-6(AUC=0.755,95%CI:0.673~0.825)、RDW(AUC=0.743,95%CI:0.660~0.815)和ELWI(AUC=0.766,95%CI:0.685~0.835)单独预测(P<0.05)。结论: 血清IL-6、RDW水平和ELWI升高与SAP并发ARDS独立相关,血清IL-6、RDW联合ELWI预测SAP并发ARDS的价值较高。

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	范志伟
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关键词 ：重症急性胰腺炎, 急性呼吸窘迫综合征, 白介素-6, 红细胞分布宽度, 血管外肺水指数

Abstract：Objective: To investigate the predictive value of serum interleukin-6 (IL-6) combined with red blood cell distribution width (RDW) and extravascular lung water index (ELWI) in severe acute pancreatitis (SAP) complicated by acute respiratory distress syndrome (ARDS). Methods: A total of 134 patients with SAP admitted to our hospital from January 2017 to July 2022 were selected and divided into 48 cases in the ARDS group and 86 cases in the non-ARDS group according to whether they had concomitant ARDS. Multifactorial logistic regression was used to analyze the influencing factors of SAP-complicated ARDS, and ROC curves were used to analyze the predictive value of serum IL-6, RDW levels, and ELWI for SAP-complicated ARDS. Results: Serum IL-6, RDW levels and ELWI were elevated in the ARDS group compared to the non-ARDS group (P<0.05). Multifactorial logistic regression analysis showed that increased respiratory rate (OR=1.042, 95% CI: 1.002 to 1.083) and IL-6 (OR=1.012, 95% CI: 1.004 to 1.019), RDW (OR=2.225, 95% CI: 1.339 to 3.696), ELWI (OR= 1.482, 95% CI: 1.193 to 1.840) were elevated as independent risk factors for SAP complicated by ARDS, and elevated oxygenation index (OR=0.990, 95% CI: 0.983 to 0.996) was an independent protective factor (P<0.05). ROC curve analysis showed that serum IL-6 and RDW combined with ELWI (AUC=0.889, 95% CI: 0.824 to 0.937) predicted a greater area under the curve (AUC) for SAP complicated by ARDS than IL-6 (AUC=0.755, 95% CI: 0.673 to 0.825), RDW (AUC=0.743, 95% CI: 0.660 to 0.815) and ELWI (AUC=0.766, 95% CI: 0.685 to 0.835) predicted individually (P<0.05). Conclusion: Elevated serum IL-6, RDW levels and ELWI were independently associated with SAP complicated by ARDS, and serum IL-6 and RDW combined with ELWI were of high value in predicting SAP complicated by ARDS.

Key words： Severe acute pancreatitis Acute respiratory distress syndrome Interleukin-6 Red blood cell distribution width Extravascular lung water index

基金资助:江苏省卫生健康委医学科研项目,(编号:JH19090)

引用本文:

范志伟, 谢振林, 毕正强. 白介素-6联合红细胞分布宽度血管外肺水指数对重症急性胰腺炎并发急性呼吸窘迫综合征的预测价值[J]. 河北医学, 2023, 29(8): 1302-1308.
FAN Zhiwei, XIE Zhenlin, BI Zhengqiang. Predictive Value of IL-6 Combination with RDW and Extravascular Lung Water Index in Severe Acute Pancreatitis Complicated by ARDS. HeBei Med, 2023, 29(8): 1302-1308.

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http://www.hbyxzzs.cn/CN/10.3969/j.issn.1006-6233.2023.08.014 或 http://www.hbyxzzs.cn/CN/Y2023/V29/I8/1302

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