BISAP评分与miR-155联合应用于预测急性胰腺炎的严重程度。
Combination of the BISAP Score and miR-155 is Applied in Predicting the Severity of Acute Pancreatitis.
作者信息
Wu Bing, Yang Jun, Dai Yonghong, Xiong Le
机构信息
Department of Critical Care Medicine, Jiangjin Central Hospital, Chongqing, People's Republic of China.
出版信息
Int J Gen Med. 2022 Sep 24;15:7467-7474. doi: 10.2147/IJGM.S384068. eCollection 2022.
PURPOSE
To evaluate the predictive value of combination of Bedside Index for Severity in AP (BISAP) score and miR-155 for the severity of acute pancreatitis (AP).
PATIENTS AND METHODS
A total of 1046 AP patients were divided into control group and case group according to the severity of AP [mild and moderately severe AP vs severe AP (SAP)]. Demographic data, comorbidities, clinical characteristics and laboratory data were collected. Multivariate analysis was conducted for the variables with two-sided <0.10 in univariate analysis to identify independent associated factors for progression to SAP in AP patients. The predictive values were evaluated using receiver operating characteristic (ROC) curve, and the area under curve (AUC) was compared using test.
RESULTS
A total of 117 (11.2%) patients were evaluated as SAP. Univariate analysis showed that there were significant differences in age, hypertension, ICU admission, hospital stay, Leukocytes, CRP, BUN, BISAP score and miR-155 between case group and control group (<0.05), and the value of Fibrinogen was <0.10. Multivariate analysis showed that the BISAP score, BUN, Leukocytes, age and CRP were independent risk factors for progression to SAP among AP patients after adjusting for hypertension, ICU admission, hospital stay and Fibrinogen, while miR-155 was a protective factor. The ROC curves demonstrated the AUCs of BISAP score, miR-155 and their combination were 0.842 (: 0.017, 95% : 0.809-0.874), 0.751 (: 0.022, 95% : 0.708-0.793) and 0.945 (: 0.007, 95% : 0.931-0.959), respectively. test showed that the AUC of combination prediction was significantly higher than that of individual predictions (0.945 vs 0.842, =5.602, <0.001; 0.945 vs 0.751, =8.403, <0.001). The sensitivity, specificity and negative predictive value (NPV) of combination prediction were 95.7%, 93.6% and 99.4%, respectively.
CONCLUSION
The combination of the BISAP score and miR-155 should be utilized to elevate the predictive value for the severity of AP in clinic.
目的
评估急性胰腺炎（AP）床边严重程度指数（BISAP）评分与miR-155联合应用对AP严重程度的预测价值。
患者与方法
根据AP严重程度[轻度和中度AP与重度AP（SAP）]将1046例AP患者分为对照组和病例组。收集人口统计学数据、合并症、临床特征及实验室数据。对单因素分析中P<0.10的变量进行多因素分析，以确定AP患者进展为SAP的独立相关因素。采用受试者工作特征（ROC）曲线评估预测价值，并用检验比较曲线下面积（AUC）。
结果
共117例（11.2%）患者被评估为SAP。单因素分析显示，病例组与对照组在年龄、高血压、入住ICU、住院时间、白细胞、CRP、BUN、BISAP评分及miR-155方面存在显著差异（P<0.05），纤维蛋白原的P值<0.10。多因素分析显示，在调整高血压、入住ICU、住院时间及纤维蛋白原后，BISAP评分、BUN、白细胞、年龄及CRP是AP患者进展为SAP的独立危险因素，而miR-155是保护因素。ROC曲线显示，BISAP评分、miR-155及其联合应用的AUC分别为0.842（SE：0.017，95%CI：0.809-0.874）、0.751（SE：0.022，95%CI：0.708-0.793）和0.945（SE：0.007，95%CI：0.931-0.959）。检验显示，联合预测的AUC显著高于单项预测（0.945对0.842，Z=5.602，P<0.001；0.945对0.751，Z=8.403，P<0.001）。联合预测的敏感度、特异度及阴性预测值（NPV）分别为95.7%、93.6%和99.4%。
结论
临床中应联合应用BISAP评分与miR-155以提高对AP严重程度的预测价值。
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