Early diagnostic value of serum pentamerin 3 in patients with acute severe pancreatitis complicated with bacterial infection

doi:10.3877/cma.j.issn.1674-1358.2020.03.010

Abstract

Abstract:

Objective

To investigate the early diagnostic value of serum pentamerin 3 (PTX3) in patients with severe acute pancreatitis complicated with bacterial infection.

Methods

Total of 106 patients with severe acute pancreatitis treated in the Department of Digestive Medicine, Huizhou Central People’s Hospital from April 2017 to April 2019 were collected, and were divided into bacterial infection group (45 cases) and non-bacterial infection group (61 cases) according to whether complicated with bacterial infection or not. While 64 healthy persons were selected as control group during the same period. The levels of serum PTX3 and procalcitonin (PCT) were detected by enzyme-linked immunosorbent assay (ELISA), the risk factors of severe acute pancreatitis complicated with bacterial infection were analyzed by multiple Logistic regression, the diagnostic values of serum PTX3 and PCT levels in severe acute pancreatitis complicated with bacterial infection were compared by the receiver operating characteristic curve (ROC).

Results

There was no significant difference in serum PTX3 and PCT levels between the non-bacterial infection group and the control group (t = 1.747, P = 0.083; U = 0.123, P = 0.903), the serum PTX3 and PCT levels in the bacterial infection group were significantly higher than those of the control group (t = 10.128, U = 8.919; all P < 0.001). Compared with non-bacterial infection group, the levels of PTX3 and PCT in the group with bacterial infection increased significantly, with significant differences (t = 8.438, U = 8.830; all P < 0.001). Binary Logistic regression analysis showed that serum PTX3 and PCT levels were independent risk factors of bacterial infection in patients with severe acute pancreatitis (OR = 2.491, 1.576; all P < 0.001). ROC curve showed that the area under the curve of serum PTX3 level was 0.830 (the sensitivity and specificity were 82.2% and 85.2%); the area under the curve of serum PCT level for the diagnosis of severe acute pancreatitis complicated with bacterial infection was 0.865 (the sensitivity and specificity were 88.9% and 88.5%), and there was no significant difference in the area under curve of serum PTX3 level and PCT level for severe acute pancreatitis complicated with bacterial infection (Z = 0.581, P = 0.561).

Conclusion

Serum PTX3 level may be a biological indicator of bacterial infection in patients with severe acute pancreatitis.

Key words: Severe acute pancreatitis, Pentamerin 3, Bacterial infection, Procalcitonin

Jiahui Xia, Yongli Wu. Early diagnostic value of serum pentamerin 3 in patients with acute severe pancreatitis complicated with bacterial infection[J]. Chinese Journal of Experimental and Clinical Infectious Diseases(Electronic Edition), 2020, 14(03): 235-240.

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References 25

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组别	例数	性别（男/女，例）	年龄（ ± s，岁）	病程（ ± s，月）	白细胞计数（ ± s，× 10⁹/L）	APACHE Ⅱ评分（ ± s）
对照组	64	39/25	45.12 ± 5.12	—	5.23 ± 0.98	—
未合并细菌感染组	61	38/23	45.53 ± 5.24	2.13 ± 0.35	13.54 ± 3.57^a	10.64 ± 2.13
合并细菌感染组	45	28/17	45.67 ± 5.22	2.25 ± 0.31	16.71 ± 4.41^ab	17.05 ± 4.16
统计量	?	χ² = 0.030	F = 0.173	—	F = 197.747	—
P值	?	0.985	0.842	—	< 0.001	—
t₁值	?	0.024	0.442	—	17.930	—
P₁值	?	0.876	0.659	—	< 0.001	—
t₂值	?	0.018	0.548	—	20.166	—
P₂值	?	0.892	0.585	—	< 0.001	—
t₃值	?	< 0.001	0.136	1.830	4.087	10.347
P₃值	?	0.994	0.892	0.070	< 0.001	< 0.001

组别	例数	性别（男/女，例）	年龄（ ± s，岁）	病程（ ± s，月）	白细胞计数（ ± s，× 10⁹/L）	APACHE Ⅱ评分（ ± s）
对照组	64	39/25	45.12 ± 5.12	—	5.23 ± 0.98	—
未合并细菌感染组	61	38/23	45.53 ± 5.24	2.13 ± 0.35	13.54 ± 3.57^a	10.64 ± 2.13
合并细菌感染组	45	28/17	45.67 ± 5.22	2.25 ± 0.31	16.71 ± 4.41^ab	17.05 ± 4.16
统计量	?	χ² = 0.030	F = 0.173	—	F = 197.747	—
P值	?	0.985	0.842	—	< 0.001	—
t₁值	?	0.024	0.442	—	17.930	—
P₁值	?	0.876	0.659	—	< 0.001	—
t₂值	?	0.018	0.548	—	20.166	—
P₂值	?	0.892	0.585	—	< 0.001	—
t₃值	?	< 0.001	0.136	1.830	4.087	10.347
P₃值	?	0.994	0.892	0.070	< 0.001	< 0.001

组别	例数	PTX3（ ± s，μg/L）	PCT [M（P25，P75），ng/ml]
对照组	64	6.12 ± 1.22	0.02（0.01，0.04）
未合并细菌感染组	61	6.52 ± 1.34	0.03（0.01，0.04）
合并细菌感染组	45	9.31 ± 2.06	7.18（0.46，13.71）
统计量	?	F = 64.903	H = 101.254
P值	?	< 0.001	< 0.001
t₁/U₁值	?	1.747	0.123
P₁值	?	0.083	0.903
t₂/U值	?	10.128	8.919
P₂值	?	< 0.001	< 0.001
t₃/U值	?	8.438	8.830
P₃值	?	< 0.001	< 0.001

组别	例数	PTX3（ ± s，μg/L）	PCT [M（P25，P75），ng/ml]
对照组	64	6.12 ± 1.22	0.02（0.01，0.04）
未合并细菌感染组	61	6.52 ± 1.34	0.03（0.01，0.04）
合并细菌感染组	45	9.31 ± 2.06	7.18（0.46，13.71）
统计量	?	F = 64.903	H = 101.254
P值	?	< 0.001	< 0.001
t₁/U₁值	?	1.747	0.123
P₁值	?	0.083	0.903
t₂/U值	?	10.128	8.919
P₂值	?	< 0.001	< 0.001
t₃/U值	?	8.438	8.830
P₃值	?	< 0.001	< 0.001

影响因素	β值	SE值	Wald χ²值	P值	OR值	95%CI值
性别	－0.634	0.437	2.110	0.146	0.530	0.225～1.248
年龄	－0.625	0.371	2.842	0.091	0.535	0.258～1.107
白细胞计数	－0.092	0.090	1.047	0.306	0.912	0.764～1.087
PTX3	0.913	0.437	4.355	< 0.001	2.491	2.131～2.914
PCT	0.455	0.316	2.070	< 0.001	1.576	1.126～2.205

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