The Assessed Value Of Pleural Effusion Combined With Serum MCP-1 And STREM-1 On Prognostic Acute Pancreatitis In The Early Stage

Objective: The paper conducts the investigation to assess the value of the severity and prognosis of acute pancreatitis by combining pleural effusion with serum monocyte chemotactic protein 1(MCP-1)and soluble triggering receptor expressed on myeloid cells 1(sTREM-1)in the early stage.Methods: The data of 75 AP patients admitted from December 2017 to December2018 were collected and divided into light disease group(31 cases)and non-light disease group(44 cases)according to the severity of the disease.40 healthy people taking physical examination at the same time served as control group.Fasting peripheral venous blood was collected from AP patients on the first,third,fifth and seventh days after admission,while fasting peripheral venous blood was collected from the control group taking physical examination at the same time on the morning of physical examination.The dynamic changes of serum MCP-1 and sTREM-1 levels and the differences between groups were analyzed,and the differences in incidence of pleural effusion and other clinical indicators between mild and non-mild groups on admission were compared.Receiver operating characteristic curve(ROC)was used to evaluate the early evaluation efficiency of various observation indicators on the severity of AP and the early prediction value of adverse prognosis related to non-light AP patients.Results: No statistical difference is found in the two groups with regard to their genders,ages,and etiological agents(P> 0.05).The C-reactive protein(CRP)level,APACHE II score,and incidence rate of pleural effusion in the non-mild group were significantly higher than what in the mild group.The length of hospital stays was also significantly longer than that in the mild group(P <0.05).On the first day of admission,serum MCP-1 and sTREM-1 levels were significantly higher in mild and non-mild disease groups than in healthy control group(p < 0.05).On the first,third,fifth and seventh days after admission,serum MCP-1 and sTREM-1 levels in the non-mild group were higher than those in the mild group(P<0.05).The standard of CRP(? 98.55 mg / L),APACHE II score(? 8),pleural effusion,MCP-1(? 27.84 pg /m L)with sTREM-1(? 0.39 ng / m L)was applied as the best cut-off value ??for analyzing the effectiveness of early assessment of AP patients,either individually or in combination.The result shows that pleural effusion combined with serum MCP-1and sTREM-1 owns the highest evaluation(AUC is 0.884,sensitivity is 93.2%,and specificity is 91.3%).In terms of complications in AP patients in non-mild group,pleural effusion combined with serum MCP-1 and sTREM-1 have certain predictive effects on various complications,especially for the early prediction of pancreatic pseudocyst,peripancreatic infection,and ARDS.The combination has the highest value and is superior to all other combinations tested in this study(P <0.05).Conclusion: The medical examination of pleural effusion combined with serum MCP-1 and sTREM-1 has certain clinical value in the assessment of AP patients and early prognosis.