The predictive value of sCD14-ST and PTX-3 in severe acute pancreatitis complicated with peripancreatic necrosis and infection

doi:10.11958/20220967

Abstract

Abstract:

Objective To explore the predictive value of serum soluble leukocyte differentiation antigen subtype 14 (sCD14 st) and pentamerin-3 (PTX-3) in severe acute pancreatitis (SAP) complicated with peripancreatic necrosis infection. Methods A total of 112 SAP patients were selected and divided into the infection group (54 cases) and the non-infection group. Cultures of pathogenic bacteria were performed in patients of the infection group. Enzyme-linked immunosorbent assay was used to detect serum levels of sCD14 st, PTX-3, procalcitonin (PCT) and C-reactive protein (CRP). Results A total of 61 strains of pathogenic bacteria were detected in the infection group, including 45 strains of Gram-negative bacteria (73.77%), 14 strains of Gram-positive bacteria (22.95%) and 2 strains of fungi (3.28%). The serum levels of sCD14-ST, PTX-3, PCT and CRP were significantly higher in the infected group than those in the non-infected group (P<0.05). Serum sCD14-ST was positively correlated with PTX-3, PCT and CRP in SAP patients (P<0.05). Serum PTX-3 was positively correlated with sCD14-ST, PCT and CRP (P<0.05). The high levels of sCD14-ST, PTX-3, PCT and CRP were the risk factors of peripancreatic necrosis infection in SAP patients (P<0.05). The areas under the curve of sCD14-ST, PTX-3, PCT and CRP predicting peripancreatic necrosis infection in SAP patients were 0.854 (95%CI: 0.784-0.925), 0.851 (95%CI: 0.780-0.923), 0.837 (95%CI: 0.756-0.919) and 0.749 (95%CI: 0.654-0.844) respectively. Conclusion The serum levels of sCD14-ST and PTX-3 are abnormally elevated in SAP patients with peripancreatic necrosis infection, and their expression levels are closely related to the risk of infection. Both of them have high predictive value for SAP patients with peripancreatic necrosis infection.

Key words: pancreatitis, acute necrotizing, bacterial infections and mycoses, prognosis, soluble leukocyte differentiation antigen 14 isoform, pentraxin-3

CLC Number:

R657.5+1

Figures/Tables 4

References 18

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组别	n	性别（男/女）	年龄（岁）		病因				BMI （kg/m²）
组别	n	性别（男/女）	年龄（岁）		胆源性		非胆源性		BMI （kg/m²）
感染组	54	34/20	57.71±4.35		32（59.26）		22（40.74）		22.09±1.33
未感染组	58	30/28	55.94±5.76		25（43.10）		33（56.90）		22.12±1.47
χ²或t		1.442	1.825		2.921				0.113
组别	sCD14-ST（ng/L）			PTX-3（μg/L）		PCT（μg/L）		CRP（mg/L）
感染组	1 183.40±331.33			10.26±2.89		4.84±1.67		89.62±22.16
未感染组	804.95±186.39			6.59±2.26		2.91±1.06		70.97±16.24
χ²或t	7.831^＊＊			7.533^＊＊		7.351^＊＊		5.105^＊＊

组别	n	性别（男/女）	年龄（岁）		病因				BMI （kg/m²）
组别	n	性别（男/女）	年龄（岁）		胆源性		非胆源性		BMI （kg/m²）
感染组	54	34/20	57.71±4.35		32（59.26）		22（40.74）		22.09±1.33
未感染组	58	30/28	55.94±5.76		25（43.10）		33（56.90）		22.12±1.47
χ²或t		1.442	1.825		2.921				0.113
组别	sCD14-ST（ng/L）			PTX-3（μg/L）		PCT（μg/L）		CRP（mg/L）
感染组	1 183.40±331.33			10.26±2.89		4.84±1.67		89.62±22.16
未感染组	804.95±186.39			6.59±2.26		2.91±1.06		70.97±16.24
χ²或t	7.831^＊＊			7.533^＊＊		7.351^＊＊		5.105^＊＊

指标	β	SE	Wald χ²	P	OR	OR 95%CI
sCD14-ST	0.654	0.205	10.178	0.001	1.923	1.287~2.874
PTX-3	0.796	0.220	13.091	0.000	2.217	1.440~3.412
PCT	0.641	0.197	10.587	0.001	1.898	1.290~2.793
CRP	0.435	0.174	6.250	0.012	1.545	1.099~2.173
常数项	0.128	0.048	7.111	0.008	1.137	-

指标	β	SE	Wald χ²	P	OR	OR 95%CI
sCD14-ST	0.654	0.205	10.178	0.001	1.923	1.287~2.874
PTX-3	0.796	0.220	13.091	0.000	2.217	1.440~3.412
PCT	0.641	0.197	10.587	0.001	1.898	1.290~2.793
CRP	0.435	0.174	6.250	0.012	1.545	1.099~2.173
常数项	0.128	0.048	7.111	0.008	1.137	-

指标	AUC	AUC 95%CI	敏感度（%）	特异度（%）	约登指数
sCD14-ST	0.854	0.784~0.925	81.48	79.31	0.608
PTX-3	0.851	0.780~0.923	79.63	81.03	0.607
PCT	0.837	0.756~0.919	77.78	81.03	0.588
CRP	0.749	0.654~0.844	72.22	77.59	0.498