The role of serum interleukin-6, red blood cell distribution width and C-reactive protein levels in the evaluation of the condition and prognosis of patients with moderate to severe acute pancreatitis and pulmonary infection / 中国医师进修杂志

ABSTRACT

Objective:To investigate the effects of blood interleukin-6 (IL-6), red blood cell distribution width (RDW) and C-reactive protein (CRP) levels in the evaluation of the condition and prognosis of patients with moderate to severe acute pancreatitis (AP) and pulmonary infection.Methods:A total of 90 patients with moderate to severe AP combined with lung infection diagnosed and treated in Anhui Wanbei Coal and Electricity Group General Hospital from January 2018 to December 2020 were selected as the observation group, and 90 patients with moderate to severe AP without lung infection during the same period were selected as the control group. The IL-6, RDW, and CRP levels of patients in the two groups were compared, and their correlation with the disease severity was analyzed; the predictive value of serum IL-6, RDW and CRP levels on the prognosis of patients were analyzed by receiver operating characteristic (ROC) curve.Results:The serum levels of IL-6, RDW and CRP in the observation group were higher than those in the control group (35.35 ± 7.19) ng/L vs. (26.91 ± 5.23) ng/L, (15.14 ± 5.36)% vs. (11.27 ± 2.07)%, (146.22 ± 50.27) mg/L vs. (102.83 ± 40.25) mg/L, and as the severity of the disease in the observation group increased, the serum IL-6, RDW and CRP levels increased, and the differences were statistically significant ( P<0.05). Serum IL-6, RDW, CRP levels of patients with moderate to severe AP combined with pulmonary infection were positively correlated with the severity of the disease ( r = 0.445, 0.610, 0.580, P<0.05). The serum levels of IL-6, RDW and CRP were higher in patients with poor prognosis when they were admitted to the hospital and on the 3rd and 7th days of admission than those with good prognosis ( P<0.05). The results of Cox regression analysis showed that serum IL-6, RDW and CRP levels at admission and on the 3rd and 7th day of admission were the prognostic factors of patients with moderate to severe AP combined with lung infection ( P<0.05). The combined detection of serum IL-6, RDW and CRP levels on the 7th day of admission had the largest area under the curve for predicting prognosis, and the sensitivity and specificity were 89.47% and 83.10%, respectively. Conclusions:The levels of serum IL-6, RDW and CRP in patients with moderate to severe AP combined with pulmonary infection are elevated, and are positively correlated with the severity of the disease. Clinical monitoring of their levels can provide a reliable reference for the formulation of treatment plans and prognostic evaluation.