Relationship between peripheral blood TLR4, IL-1β and NLR and the progression and prognosis of acute pancreatitis

doi:10.11958/20231354

Abstract

Abstract:

Objective To study the relationship between peripheral blood Toll like receptor 4 (TLR4), interleukin-1β (IL-1β) and neutrophil-to-lymphocyte ratio (NLR) and the progression and prognosis of acute pancreatitis (AP). Methods A total of 250 patients with AP were divided into the mild group (121 cases), the moderately severe group (89 cases) and the severe group (40 cases) according to the disease severity. Patients were divided into the poor prognosis group (33 cases) and the good prognosis group (217 cases) based on the prognosis after 5 days of treatment. Peripheral blood levels of TLR4, IL-1β and NLR were compared at different time points, different conditions and different prognosis in patients. The correlation of peripheral blood levels of TLR4, IL-1β and NLR, Ranson score and amylase were analyzed by Pearson correlation analysis. The value of each indicator in the diagnosis of severe AP was analyzed using ROC curve, and multivariate Logistic regression analysis was conducted to identify the prognostic risk factors. Results TLR4, IL-1β and NLR levels in AP patients were higher 24 h after admission than 48 h and 72 h after admission (P<0.05). Peripheral blood TLR4 and IL-1β levels in AP patients at 24 h after admission increased with the condition became worse. NLR level was higher in the severe group than that in the moderately group or the mild group (P<0.05). Peripheral blood TLR4, IL-1β and NLR levels in AP patients 24 h after admission were positively correlated with Ranson score at 48 h after admission and amylase level at 24 h after admission (P<0.05). The area under ROC curve, sensitivity and specificity of the combination of TLR4, IL-1β and NLR at 24 h after admission for predicting severe AP were 0.895, 84.53% and 81.69%. Peripheral blood TLR4, IL-1β and NLR levels 24 h after admission were higher in the poor prognosis group than those in the good prognosis group (P<0.05). Multivariate Logistic regression analysis showed that elevated TLR4, IL-1β and NLR at 24 h after admission were independent risk factors for poor prognosis of patients with AP (P<0.05). Conclusion Peripheral blood TLR4, IL-1β and NLR in patients with AP are closely related to disease progression and prognosis. Therefore, they can be taken as important monitoring indicators.

Key words: pancreatitis, Toll-like receptor 4, interleukin-4, prognosis, neutrophil-to-lymphocyte ratio

CLC Number:

R576

Figures/Tables 6

References 18

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时间	TLR4	IL-1β/（ng/L）	NLR
入院24 h	0.63±0.09	19.69±2.53	9.09±1.16
入院48 h	0.45±0.05^a	18.56±5.02^a	8.30±1.81^a
入院72 h	0.39±0.08^ab	15.37±2.77^ab	7.11±0.79^ab
F	588.684^＊＊	157.564^＊＊	237.613^＊＊

时间	TLR4	IL-1β/（ng/L）	NLR
入院24 h	0.63±0.09	19.69±2.53	9.09±1.16
入院48 h	0.45±0.05^a	18.56±5.02^a	8.30±1.81^a
入院72 h	0.39±0.08^ab	15.37±2.77^ab	7.11±0.79^ab
F	588.684^＊＊	157.564^＊＊	237.613^＊＊

组别	n		入院48 h Ranson评分/分		入院24 h TLR4
轻症组	121		1.95±0.22		0.60±0.08
中重症组	89		3.02±0.15^a		0.65±0.07^a
重症组	40		4.58±0.78^ab		0.76±0.07^ab
F			853.356^＊＊		68.936^＊＊
组别		入院24 h IL-1β/（ng/L）		入院24 h NLR
轻症组		18.84±2.09		8.86±0.94
中重症组		19.94±1.67^a		9.05±0.83
重症组		23.01±2.42^ab		10.37±1.49^ab
F		64.597^＊＊		34.538^＊＊

组别	n		入院48 h Ranson评分/分		入院24 h TLR4
轻症组	121		1.95±0.22		0.60±0.08
中重症组	89		3.02±0.15^a		0.65±0.07^a
重症组	40		4.58±0.78^ab		0.76±0.07^ab
F			853.356^＊＊		68.936^＊＊
组别		入院24 h IL-1β/（ng/L）		入院24 h NLR
轻症组		18.84±2.09		8.86±0.94
中重症组		19.94±1.67^a		9.05±0.83
重症组		23.01±2.42^ab		10.37±1.49^ab
F		64.597^＊＊		34.538^＊＊

指标	AUC	AUC95%CI	P	敏感度/%	特异度/%
TLR4	0.808	0.745~0.871	<0.001	78.45	74.56
IL-1β	0.772	0.698~0.846	<0.001	76.22	75.68
NLR	0.701	0.601~0.800	<0.001	73.41	69.47
联合检测	0.895	0.852~0.938	<0.001	84.53	81.69