The clinical value of dynamic monitoring of serum heparin binding protein, procalcitonin and IL-18 in evaluating the severity of acute pancreatitis / 中华肝胆外科杂志

ABSTRACT

Objective:To investigate the correlations between level of serum heparin binding protein (HBP), procalcitonin (PCT), interleukin-18 (IL-18) and the severity of acute pancreatitis (AP).Methods:A total of 86 patients with AP admitted to the First Affiliated Hospital, University of Science and Technology of China from December 2017 to May 2019 were included and divided into mild AP group (MAP) with 36 cases, moderate AP group (MSAP) with 26 cases, and severe AP group (SAP) with 24 cases. There were 25 healthy subjects were chosen as the control group. Serum HBP, PCT, and IL-18 levels were dynamically monitored in all patients at 1, 3 and 7 days after admission. The Spearman correlation analysis was conducted to detect the correlation between the three indicators and inflammatory factors IL-6, IL-8, TNF-α, and APACHEII and Ranson score, and analyzed the early diagnostic value of HBP, PCT, and IL-18 in SAP patients.Results:In 86 AP patients, 53 were males and 33 were females, aged (48.3±8.0) years. In 25 healthy subjects, 15 were males and 10 were females, aged (40.5±5.9) years. Serum levels of HBP, PCT and IL-18 in AP patients were significantly higher than those of healthy control group at 1, 3 and 7 days after admission ( P<0.05), and the most significant increase was observed on the 1st day. At the meanwhile, HBP, PCT, and IL-18 were positively correlated with level of IL-6, IL-8, TNF-α, APACHEII and Ranson scores ( P<0.05). The AUC area of SAP diagnosis by using HBP, PCT or IL-18 alone was respectively 0.825, 0.896, 0.799, the Yoden index was respectively 0.605, 0.628, 0.583, the sensitivity and specificity were 75.3%, 76.2%, 74.8% and 85.2%, 86.6%, 83.5%. The AUC area, Yoden index, sensitivity and specificity of joint detection were 0.923, 0.787, 85.5%, 93.2%, and the positive predictive value and negative predictive value were also increased. Conclusion:Monitoring of serum HBP, PCT and IL-18 can predict the severity of AP patients, and it may serve as an early diagnostic marker for AP.