Rao Shilpa A, Kunte Aditya R
Department of General Surgery, KEM Hospital, Seth G.S. Medical College, Mumbai, Maharashtra, India.
Indian J Crit Care Med. 2017 Jul;21(7):424-428. doi: 10.4103/ijccm.IJCCM_478_16.
Interleukin (IL)-6, IL-8, IL-10, and C-reactive protein (CRP) have been evaluated for predicting outcomes of acute pancreatitis. However, there is considerable variation in their performance among different studies. We evaluate their accuracy in predicting progression to severe pancreatitis.
Serum IL-6, IL-8, IL-10, and CRP levels were measured within 24 h of admission in forty patients of clinically predicted severe acute pancreatitis (SAP). Persistent organ failure (>48 h) defined SAP. The performance of inflammatory markers was evaluated in predicting the progression of pancreatitis.
IL-6 ≥28.90 pg/mL had a sensitivity of 62.86%, specificity of 80%, positive predictive value (PPV) of 95.65%, LR+ of 3.1429, LR- of 0.4643, and diagnostic odds ratio (DOR) of 6.7692; IL-8 ≥88.70 pg/mL had a sensitivity of 60%, specificity of 80%, PPV of 95.45%, LR+ of 3.000, LR- of 0.5000, and DOR of 6.000; IL-10 ≤5.70 pg/mL had DOR of 0.2647, sensitivity of 51.43%, specificity of 20%, PPV of 81.82%, LR+ of 0.6429, and LR- of 2.4286. CRP ≥110.00 mg/L had DOR of 2.3636, sensitivity of 37.14%, specificity of 80%, PPV of 92.86%, LR+ of 1.8571, and LR of 0.7857.
IL-6 ≥28.90 pg/mL, measured within 48 h of onset is the best among the tested biomarkers in this study for predicting the progression to severe pancreatitis.
白细胞介素(IL)-6、IL-8、IL-10和C反应蛋白(CRP)已被评估用于预测急性胰腺炎的预后。然而,不同研究中它们的表现存在相当大的差异。我们评估它们在预测进展为重症胰腺炎方面的准确性。
对40例临床预测为重症急性胰腺炎(SAP)的患者在入院24小时内测定血清IL-6、IL-8、IL-10和CRP水平。持续性器官功能衰竭(>48小时)定义为SAP。评估炎症标志物在预测胰腺炎进展方面的表现。
IL-6≥28.90 pg/mL的敏感性为62.86%,特异性为80%,阳性预测值(PPV)为95.65%,阳性似然比(LR+)为3.1429,阴性似然比(LR-)为0.4643,诊断比值比(DOR)为6.7692;IL-8≥88.70 pg/mL的敏感性为60%,特异性为80%,PPV为95.45%,LR+为3.000,LR-为0.5000,DOR为6.000;IL-10≤5.70 pg/mL的DOR为0.2647,敏感性为51.43%,特异性为20%,PPV为81.82%,LR+为0.6429,LR-为2.4286。CRP≥110.00 mg/L的DOR为2.3636,敏感性为37.14%,特异性为80%,PPV为92.86%,LR+为1.8571,LR为0.7857。
在发病48小时内测得的IL-6≥28.90 pg/mL是本研究中测试的生物标志物中预测进展为重症胰腺炎的最佳指标。