血清CXCL10、CXCL12与高脂血症性急性胰腺炎患者病情严重程度及预后的关系

Association of serum CXCL10 and CXCL12 with the severity and prognosis of hyperlipidemic acute pancreatitis

摘要:

目的 探究血清CXC趋化因子配体10（CXCL10）、CXC趋化因子配体12（CXCL12）与高脂血症性急性胰腺炎（HLAP）患者病情严重程度及预后的关系。方法 选取2020年6月—2022年6月在康复大学青岛中心医院和青岛市中医医院就诊的126例HLAP患者，根据病情严重程度分为轻症组（55例）、中度重症组（43例）、重症组（28例），根据患者预后情况分为预后良好组（107例）和预后不良组（19例）。比较血清CXCL10、CXCL12在不同组别中的表达情况，采用多因素一般Logistic模型分析HLAP患者预后的影响因素并构建列线图，绘制受试者工作特征（ROC）曲线分析血清CXCL10和CXCL12对HLAP患者预后的预测价值。结果 重症组CXCL10、CXCL12水平均高于轻症组、中度重症组（P <0.05）。预后不良组的急性胰腺炎严重程度床旁指数评分、C反应蛋白（CRP）、甘油三酯（TG）、MCTSI评分、乳酸、CXCL10和CXCL12水平均高于预后良好组（P <0.05）。多因素一般Logistic回归分析，结果显示：CRP水平高［O^R=1.086（95% CI：1.004，1.174）］、TG水平高［O^R=1.851（95% CI：1.080，3.172）］、CXCL10水平高［O^R=1.107（95% CI：1.035，1.185）］和CXCL12水平高［O^R=1.063（95% CI：1.008，1.122）］均为HLAP患者预后不良的危险因素（P <0.05）。ROC曲线结果表明，血清CXCL10和CXCL12联合预测HLAP患者预后的敏感性和特异性分别为94.7%（95% CI：0.740，0.999）和95.3%（95% CI：0.894，0.985）。结论 血清CXCL10和CXCL12水平与HLAP患者病情严重程度有关，且对HLAP患者预后有着良好的预测价值。

Abstract:

Objective To investigate the association of serum CXC chemokine ligand 10 (CXCL10) and CXC chemokine ligand 12 (CXCL12) with the severity and prognosis of hyperlipidemic acute pancreatitis (HLAP).Methods A total of 126 HLAP patients admitted to Qingdao Central Hospital and Qingdao Traditional Chinese Medicine Hospital from June 2020 to June 2022 were selected. They were divided into the mild group (n = 55), moderately severe group (n = 43) and severe group (n = 28) according to the severity of the disease, and into the good prognosis group (n = 107) and poor prognosis group (n = 19) according to the prognosis of the patients. The expressions of serum CXCL10 and CXCL12 in different groups were compared. Multivariable logistic regression analysis was performed to identify prognostic factors in HLAP patients, based on which a nomogram was constructed. Receiver operating characteristic (ROC) curve was established to analyze the predictive value of serum CXCL10 and CXCL12 for the prognosis of HLAP patients.Results The levels of CXCL10 and CXCL12 in the severe group were higher than those in the mild and moderately severe groups (P < 0.05). The BISAP and MCTSI scores, and levels of CRP, TG, lactic acid, CXCL10 and CXCL12 in the poor prognosis group were all higher than those in the good prognosis group (P < 0.05). The multivariable logistic regression analysis showed that high CRP level [O^R = 1.086 (95% CI: 1.004, 1.174) ], high TG level [O^R = 1.851 (95% CI: 1.080, 3.172) ], high CXCL10 level [O^R = 1.107 (95% CI: 1.035, 1.185) ] and high CXCL12 level [O^R = 1.063 (95% CI: 1.008, 1.122) ] were all risk factors for poor prognosis in HLAP patients (P < 0.05). The ROC curve analysis revealed that the sensitivity and specificity of the combined detection of serum CXCL10 and CXCL12 for predicting the prognosis of HLAP patients were 94.7% (95% CI: 0.740, 0.999) and 95.3% (95% CI: 0.894, 0.985), respectively.Conclusion Serum CXCL10 and CXCL12 are significantly associated with the severity of HLAP and have good predictive value for the prognosis of HLAP patients.