Department of Gastroenterology, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
Department of Pharmacology, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
Cytokine. 2020 Sep;133:155177. doi: 10.1016/j.cyto.2020.155177. Epub 2020 Jun 25.
To study the natural course of patients with acute pancreatitis (AP) with acute kidney injury (AKI) and their cytokine profile.
Natural course of patients with AP and AKI was studied in 97 individuals. Levels of TNFα, IL-6, IL-10, IL-8 and IL-1β were measured at presentation and at 72 h in patients who developed AKI.
Amongst the entire cohort, 16.4% patients developed AKI (persistent AKI - 11 patients, transient AKI - 5 patients). Mortality rate was 25% amongst patients with AKI. Levels of IL-6 (p = 0.035) and IL-8 (p = 0.002) were found to be significantly higher in the AKI group. On multivariate analysis, IL-8 levels at baseline were found to be an independent predictor of AKI. AKI group had significant rise of TNF-α (P < 0.001), IL-6 (P < 0.001) and IL- 1β (P < 0.001) on day 3 whereas persistent-AKI group had significant rise of TNF-α (p = 0.031), IL-6 (p = 0.001) and IL-1β on day 3 and significant decline of IL-10 (p = 0.015). Using a cut-off of 105 pg/ml, IL-8 levels at baseline could predict AKI with a sensitivity of 87.5% and specificity of 59.2%, with area under the curve being 0.744 (p = 0.002).
AP patients developing AKI have poor prognosis. IL-8 levels can predict AKI in patients with AP.
研究伴有急性肾损伤（AKI）的急性胰腺炎（AP）患者的自然病程及其细胞因子谱。
对 97 例 AP 合并 AKI 患者的自然病程进行研究。在发生 AKI 的患者中，于入院时及 72 小时检测 TNF-α、IL-6、IL-10、IL-8 和 IL-1β 的水平。
在整个队列中，16.4%的患者发生 AKI（持续性 AKI-11 例，一过性 AKI-5 例）。AKI 患者的死亡率为 25%。AKI 组的 IL-6（p=0.035）和 IL-8（p=0.002）水平明显升高。多变量分析发现，基线时的 IL-8 水平是 AKI 的独立预测因子。AKI 组在第 3 天 TNF-α（P<0.001）、IL-6（P<0.001）和 IL-1β（P<0.001）显著升高，而持续性 AKI 组在第 3 天 TNF-α（p=0.031）、IL-6（p=0.001）和 IL-1β显著升高，IL-10 水平显著下降（p=0.015）。使用 105pg/ml 的截断值，基线时的 IL-8 水平可以预测 AKI，其敏感性为 87.5%，特异性为 59.2%，曲线下面积为 0.744（p=0.002）。
发生 AKI 的 AP 患者预后不良。IL-8 水平可以预测 AP 患者的 AKI。
