|
|
|
| Predictive Value of IL-6 Combination with RDW and Extravascular Lung Water Index in Severe Acute Pancreatitis Complicated by ARDS |
| FAN Zhiwei, XIE Zhenlin, BI Zhengqiang |
| Jiangbei Hospital, Zhongda Hospital, Southeast University, Jiangsu Nanjing 210044, China |
|
|
|
|
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.
|
|
|
|
|
|
[1] 黄文炼,刘鸿雁,祝瑞,等.重症急性胰腺炎并发急性呼吸窘迫综合征发病特点、死亡因素分析及风险评估模型的建立[J].安徽医药,2022,26(6):1187-1192.
[2] 景光旭,梁鸿寅,黄竹,等.重症急性胰腺炎相关肺损伤机制与治疗的研究进展[J].中国普通外科杂志,2022,31(3):405-409.
[3] Ridker PM,Rane M.Interleukin-6 signaling and anti-interleukin-6 therapeutics in cardiovascular disease[J].Circ Res,2021,128(11):1728-1746.
[4] 马梅芳,于晓丹,刘永铭.红细胞分布宽度与常见呼吸系统疾病关系的研究进展[J].医学综述,2021,27(10):1966-1971.
[5] Rasch S,Schmidle P,Sancak S,et al.Increased extravascular lung water index (EVLWI) reflects rapid non-cardiogenic oedema and mortality in COVID-19 associated ARDS[J].Sci Rep,2021,11(1):11524.
[6] 中华医学会外科学分会胰腺外科学组.急性胰腺炎诊治指南(2014版)[J].中华消化外科杂志,2015,14(1):1-5.
[7] Ards Definition Task Force.Acute respiratory distress syndrome:the berlin definition[J].JAMA,2012,307(23):2526-2533.
[8] 宁熙,李云轩,王泽辰,等.血清降钙素原、白细胞介素6和C反应蛋白在脓毒血症和全身炎症反应综合征鉴别研究[J].中国热带医学,2022,22(11):1047-1050.
[9] Persic V,Jerman A,Malgaj Vrecko M,et al.Effect of cytosorb coupled with hemodialysis on interleukin-6 and hemodynamic parameters in patients with systemic inflammatory response syndrome:a retrospective cohort study[J].Clin Med,2022,11(24):7500.
[10] 王念,唐泽,蒋世双,等.白细胞介素-6/糖蛋白130/转录激活因子3通路在百草枯诱导小鼠急性肺损伤中的作用机制[J].中国急救医学,2021,41(3):233-237.
[11] 邵从军.红细胞分布宽度在临床疾病诊疗中的研究进展[J].临床输血与检验,2021,23(3):400-404.
[12] 涂贤,戢奇,黄燨,等.红细胞分布宽度评估急性胰腺炎严重程度的研究进展[J].胃肠病学,2021,26(1):53-56.
[13] Hu B,Cao J,Hu Y,et al.Relationship between red blood cell distribution width and all-cause mortality in disseminated intravascular coagulation patients:a retrospective analysis[J].Int Gen Med,2021,11(14):8301-8309.
[14] Mayr U,Lukas M,Habenicht L,et al.B-lines scores derived from lung ultrasound provide accurate prediction of extravascular lung water index:an observational study in critically Ill patients[J].Intensive Care Med,2022,37(1):21-31.
[15] 中国老年医学学会烧创伤分会.脉搏轮廓心排血量监测技术在严重烧伤治疗中应用的全国专家共识(2018版)[J].中华烧伤杂志,2018,34(11):776-781. |
|
|
|
2023, Vol. 29 
