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基于炎症相关因子的急性胰腺炎器官衰竭预测模型的建立:一项回顾性队列研究。

Development an Inflammation-Related Factor-Based Model for Predicting Organ Failure in Acute Pancreatitis: A Retrospective Cohort Study.

机构信息

Pancreas Center, First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Nanjing, 210029 Jiangsu Province, China.

Pancreas Institute, Nanjing Medical University, Nanjing, 210029 Jiangsu Province, China.

出版信息

Mediators Inflamm. 2021 Sep 10;2021:4906768. doi: 10.1155/2021/4906768. eCollection 2021.

Abstract

Several inflammation-related factors (IRFs) have been reported to predict organ failure of acute pancreatitis (AP) in previous clinical studies. However, there are a few shortcomings in these models. The aim of this study was to develop a new prediction model based on IRFs that could accurately identify the risk for organ failure in AP. . 100 patients with their clinical information and IRF data (levels of 10 cytokines, percentages of different immune cells, and data obtained from white blood cell count) were retrospectively enrolled in this study, and 94 patients were finally selected for further analysis. Univariate and multivariate analysis were applied to evaluate the potential risk factors for the organ failure of AP. The area under the ROC curve (AUCs), sensitivity, and specificity of the relevant model were assessed to evaluate the prediction ability of IRFs. A new scoring system to predict the organ failure of AP was created based on the regression coefficient of a multivariate logistic regression model. . The incidence of OF in AP patients was nearly 16% (15/94) in our derivation cohort. Univariate analytic data revealed that IL6, IL8, IL10, MCP1, CD3+ CD4+ T lymphocytes, CD19+ B lymphocytes, PCT, APACHE II score, and RANSON score were potential predictors for AP organ failure, and IL6 ( = 0.038), IL8 ( = 0.043), and CD19+B lymphocytes ( = 0.045) were independent predictors according to further multivariate analysis. In addition, a preoperative scoring system (0-11 points) was constructed to predict the organ failure of AP using these three factors. The AUC of the new score system was 0.86. The optimal cut-off value of the new scoring system was 6 points. . Our prediction model (based on IL6, IL8, and CD19+ B Lymphocyte) has satisfactory working efficiency to identify AP patients with high risk of organ failure.

摘要

几项炎症相关因素 (IRFs) 在先前的临床研究中被报道可预测急性胰腺炎 (AP) 的器官衰竭。然而,这些模型存在一些不足。本研究旨在开发一种基于 IRFs 的新预测模型,以准确识别 AP 器官衰竭的风险。 回顾性纳入了 100 例患者的临床资料和 IRF 数据(10 种细胞因子水平、不同免疫细胞的百分比以及白细胞计数数据),最终有 94 例患者被选入进一步分析。应用单因素和多因素分析评估 AP 器官衰竭的潜在危险因素。通过评估相关模型的 ROC 曲线下面积(AUCs)、灵敏度和特异性,评估 IRFs 的预测能力。根据多元逻辑回归模型的回归系数,创建了一种新的预测 AP 器官衰竭的评分系统。 在我们的推导队列中,AP 患者的 OF 发生率接近 16%(15/94)。单因素分析数据显示,IL6、IL8、IL10、MCP1、CD3+CD4+T 淋巴细胞、CD19+B 淋巴细胞、PCT、APACHE II 评分和 RANSON 评分是 AP 器官衰竭的潜在预测因子,进一步的多因素分析显示,IL6(=0.038)、IL8(=0.043)和 CD19+B 淋巴细胞(=0.045)是独立的预测因子。此外,使用这三个因素构建了一个用于预测 AP 器官衰竭的术前评分系统(0-11 分)。新评分系统的 AUC 为 0.86。新评分系统的最佳截断值为 6 分。 我们的预测模型(基于 IL6、IL8 和 CD19+B 淋巴细胞)在识别具有高器官衰竭风险的 AP 患者方面具有令人满意的工作效率。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1d9c/8449737/36bd0883e9bd/MI2021-4906768.001.jpg

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