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    Value of inflammatory factors combined with Ranson scores in predicting the severity of acute pancreatitis and guiding clinical treatment

    Zhang Jing;Diao Panya;Gou Yuanyuan;Department of Gastroenterology,Jiangjin Central Hospital of Chongqing;  
    Objective To analyze the value of inflammatory factors combined with Ranson scores in predicting the severity of acute pancreatitis(AP)and guiding clinical treatment.Methods According to the 2012 Atlanta standard,150 AP patients were divided into mild group(n = 50),moderate group(n =50)and severe group(n = 50).Serum inflammatory factors[interleukin(IL)-6,procalcitonin(PCT),C-reactive protein(CRP),IL-8,IL-10]levels,Ranson scores in 3 groups were compared and the mortality rate of each group was counted.Draw the receiver operating characteristics(ROC)curve.The area under the ROC(AUC)of each index was calculated and and the value of each index to assess organ failure and mortality rate was compared.Results PCT,IL-6 and CRP increased gradually at 12 h,24 h,48 h in the three groups,and PCT,IL-6 and CRP increased gradually with the severity of the disease(P0.05).The IL-10 levels in the three groups were higher at 24 h than those at 12 h,but the IL-10 levels were lower at 48 h than those at 24 h(P0.05).The Ranson scores of the light,moderate and severe groups showed an increasing trend with the increase of the severity of the disease(P0.05).The mortality rate of severe group was higher than that of mild group(0)and moderate group(2.0%,P0.05).Among the serum inflammatory factors,the AUCs of IL-6 to evaluate organ failure and mortality rate were larger than that of PCT and CRP.The AUC of CRP to evalute pancreatic necrosis was larger than that of PCT and IL-6.The AUCs of Ranson scores to evaluate organ failure and fatality rate were larger than that of PCT,IL-6 and CRP.The AUCs of PCT + IL-6 + CRP + Ranson scores to evaluate organ failure,pancreatic necrosis and fatality rate were larger than those of Ranson score and any serum inflammatory factor.Conclusion IL-6 has higher predictive value for organ failure and mortality rate in AP patients,and CRP has higher predicitvie value for pancreatic necrosis.The combination of PCT,IL-6,CRP and Ranson scores can further improve the predictive ability of organ failure,pancreatic necrosis and mortality rate,which provides a reference for the selection of clinical treatment strategies.
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