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炎症细胞因子与急性胰腺炎院内并发症的关系。

The relationship between inflammatory cytokines and in-hospital complications of acute pancreatitis.

机构信息

Department of Gastroenterology, Xuzhou Medical University, Xuzhou, China.

Department of Gastroenterology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, China.

出版信息

Immun Inflamm Dis. 2024 Feb;12(2):e1203. doi: 10.1002/iid3.1203.

Abstract

OBJECTIVE

Acute necrotic collection (ANC), acute peripancreatic fluid collection (APFC), pleural effusion, and ascites are common early complications of acute pancreatitis. This study aimed to investigate the relationship between 12 serum cytokines and the early complications and severity of acute pancreatitis (AP).

METHODS

We retrospectively analyzed the clinical data of 307 patients with AP, and divided them into severe group and mild-to-moderate group according to the revised Atlanta classification. Propensity score matching was used to control for confounding factors. Binary logistic regression analysis was used to explore the relationship between cytokine levels and early complications of AP.

RESULTS

Serum levels of interleukin (IL)-1β, IL-5, IL-6, IL-8, IL-10, IL-17, and tumor necrosis factor-α were significantly higher in the severe acute pancreatitis (SAP) group than in the non-SAP group (p < .05). After adjusting for confounding factors, the upper quartiles of IL-6, IL-8, and IL-10 were associated with an increased risk of ANC compared with those in the lowest quartile (IL-6: quartile 3, odds ratio [OR] = 3.99, 95% confidence interval [CI] = 1.95-8.16; IL-8: quartile 4, OR = 2.47, 95% CI = 1.27-4.84; IL-10: quartile 2, OR = 2.22, 95% CI = 1.09-4.56). APFC was associated with high serum levels of IL-6 (quartile 3, OR = 1.32, 95% CI = 1.02-1.72), pleural effusions were associated with high serum levels of IL-1β, IL-6, IL-8, and IL-10 (IL-1β: quartile 4, OR = 2.36, 95% CI = 1.21-4.58; IL-6: quartile 3, OR = 4.67, 95% CI = 2.27-9.61; IL-8: quartile 3, OR = 2.95, 95% CI = 1.51-5.79; IL-10: quartile 4, OR = 3.20, 95% CI = 1.61-6.36), and high serum levels of IL-6 and IL-10 were associated with an increased risk of ascites (IL-6: quartile 3, OR = 3.01, 95% CI = 1.42-6.37; IL-10: quartile 3, OR = 2.57, 95% CI = 1.23-5.37).

CONCLUSION

Serum cytokine levels, including IL-1β, IL-6, IL-8, and IL-10 may be associated with the occurrence of early complications of AP. In daily clinical practice, IL-6 may be the most worthwhile cytokine to be detected.

摘要

目的

急性坏死性积聚(ANC)、急性胰周液体积聚(APFC)、胸腔积液和腹水是急性胰腺炎(AP)早期常见的并发症。本研究旨在探讨 12 种血清细胞因子与急性胰腺炎(AP)早期并发症和严重程度的关系。

方法

我们回顾性分析了 307 例 AP 患者的临床资料,并根据修订的亚特兰大分类将其分为重症组和中轻症组。采用倾向性评分匹配法控制混杂因素。采用二项逻辑回归分析探讨细胞因子水平与 AP 早期并发症的关系。

结果

重症急性胰腺炎(SAP)组血清白细胞介素(IL)-1β、IL-5、IL-6、IL-8、IL-10、IL-17 和肿瘤坏死因子-α水平明显高于非 SAP 组(p<0.05)。校正混杂因素后,IL-6、IL-8 和 IL-10 的上四分位数与 ANC的发生风险增加有关,与下四分位数相比(IL-6:三分位数,比值比[OR] = 3.99,95%置信区间[CI] = 1.95-8.16;IL-8:四分位数,OR = 2.47,95% CI = 1.27-4.84;IL-10:四分位数 2,OR = 2.22,95% CI = 1.09-4.56)。APFC 与高血清 IL-6 水平有关(三分位数,OR = 1.32,95% CI = 1.02-1.72),胸腔积液与高血清 IL-1β、IL-6、IL-8 和 IL-10 水平有关(IL-1β:四分位数 4,OR = 2.36,95% CI = 1.21-4.58;IL-6:三分位数,OR = 4.67,95% CI = 2.27-9.61;IL-8:三分位数,OR = 2.95,95% CI = 1.51-5.79;IL-10:四分位数 4,OR = 3.20,95% CI = 1.61-6.36),高血清 IL-6 和 IL-10 水平与腹水的发生风险增加有关(IL-6:三分位数,OR = 3.01,95% CI = 1.42-6.37;IL-10:三分位数,OR = 2.57,95% CI = 1.23-5.37)。

结论

血清细胞因子水平,包括 IL-1β、IL-6、IL-8 和 IL-10,可能与 AP 早期并发症的发生有关。在日常临床实践中,IL-6 可能是最值得检测的细胞因子。

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