| Background/Aims: To explore serum inflammatory factors procalcitonin(PCT),interleukin-6(IL-6),tumor necrosis factor alpha(TNF-?)and myocardial injury markers high-sensitivity troponin T(hs Tn T),N-terminal brain sodium The dynamic changes of peptide precursor(NT-pro BNP)in patients with different types of acute pancreatitis and the predictive value of changes in the condition,so as to better evaluate the severity of the condition of patients with acute pancreatitis,and guide further diagnosis and treatment.Methods: A total of 122 patients with eligible acute pancreatitis who were treated in the emergency department and intensive care unit of Qingdao University from June 2016 to June2018 were enrolled in this study.Among them,42 patients with mild acute pancreatitis(MAP)There were 39 patients with moderate acute pancreatitis(MSAP)and 41 patients with severe acute pancreatitis(SAP).After admission,strict comprehensive medical treatments such as fasting water,fluid resuscitation,gastrointestinal decompression,acid suppression,enzyme inhibition,antibiotics and intravenous nutrition support were given according to the guidelines,and were collected on the first,third and seventh days after admission.Venous blood was measured for PCT,IL-6,TNF-?,hs Tn T,and NT-pro BNP levels,and all patients underwent acute physiology and chronic health scoring system II(APACHE II)score,CT severity index(CTSI)score,and severity bed.Edge Index(BISAP)score.According to 41 patients with severe acute pancreatitis,they were divided into infected group(23 cases)and uninfected group(18 cases).Then compare whether the differences in the levels of PCT,IL-6,TNF-?,hs Tn T and NT-pro BNP between the different types of pancreatitis group are statistically significant,depending on the age composition of the patient,gender,whether hypertension,diabetes,etc.The differences in living habits such as diseases and whether there are alcohol and tobacco hobbies are grouped and compared.And explore its relationship with the prognosis of acute pancreatitis.Results: There were no significant differences in the lifestyles of patients with different types of pancreatitis in terms of gender and age,whether they had hypertension,diabetes,and whether there were alcohol and tobacco hobbies.Serum PCT,IL-6,TNF-?,hs Tn T and NT-pro BNP levels in patients with acute pancreatitis peaked on the third day with the onset of onset,and began to decline on the 7th day;the first,third and seventh days of the SAP group Serum PCT,IL-6,TNF-?,hs Tn T and NT-pro BNP levels were higher than those in MAP group and MSAP group,the difference was statistically significant(P<0.05).The levels of serum PCT,IL-6,TNF-?,hs Tn T and NT-pro BNP in the MSAP group were higher than those in the MAP group(P<0.05).Pearson correlation analysis showed that serum PCT,IL-6,TNF-?,APACHEII score,CTSI score,and BISAP score were positively correlated with hs Tn T and NT-pro BNP in 41 patients with SAP(P<0.05).The levels of serum PCT,IL-6,TNF-?,hs Tn T and NT-pro BNP in the infected group were significantly higher than those in the uninfected group(P<0.05).The ROC curve is used to express the predictive power of five indicators for SAP.The results show that hs Tn T has the greatest predictive power for SAP(AUC=0.892),and NT-pro BNP has the least predictive ability for SAP(AUC=0.729).The indicator has a higher predictive power for SAP(AUC=0.961 vs AUC=0.932,P<0.05).Conclusion:Serum PCT,IL-6,TNF-? in SAP patients were positively correlated with hs TnT and NT-pro BNP.Dynamic monitoring of five indicators of serum PCT,IL-6,TNF-?,hs Tn T,and NT-pro BNP contributes to the assessment of the severity of acute pancreatitis and the prognosis of the disease.The new index combined prediction model is significantly better than that of the traditional index combined prediction model. |
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