Correlation of SIGIRR, IL-1, Treg/Th17, NLR with severity and prognosis of acute pancreatitis secondary sepsis

doi:10.3877/cma.j.issn.2095-2015.2025.03.012

Abstract

Abstract:

Objective

To investigate the associations between single Ig interleukin-1-related receptor (SIGIRR), interleukin-1 (IL-1), regulatory T cells (Treg)/helper T cell 17 (Th17) and neutrophil/lymphocyte ratio (NLR) and the severity and prognosis of patients with acute pancreatitis.

Methods

The clinical data of 120 patients with acute pancreatitis admitted to Ankang People's Hospital from January 2021 to January 2024 were retrospectively analyzed.According to the severity of the patients' conditions,they were divided into two groups: 56 patients in the secondary sepsis group and 64 patients in the non-secondary sepsis group, and 50 healthy patients with physical examination during the same period were selected as the control group.The patients were followed up for 1 month.According to the prognosis of the patients, they were divided into a survival group (86 cases) and a death group (34 cases).SIGIRR,IL-1, Treg/Th17, NLR and other data in peripheral blood of all subjects were collected, and the difference of indicator levels among different groups of patients was compared.Spearman was used to analyze the correlation between SIGIRR, IL-1, Treg/Th17 and NLR in peripheral blood and the severity and prognosis of patients with acute pancreatitis secondary sepsis.Logistic multi-factor regression model was used to evaluate the performance.Receiver operating characteristic (ROC) curve was drawn and the area under the curve was calculated to evaluate the prognostic value of each index in acute pancreatitis secondary sepsis.

Results

The levels of SIGIRR, IL-1, Treg/Th17 and NLR in acute pancreatitis secondary sepsis group were higher than those in non-secondary sepsis group and control group, and the levels of all indexes in non-secondary sepsis group were higher than those in control group (P<0.05).The levels of SIGIRR, IL-1,Treg/Th17 and NLR in the death group were all higher than those in the survival group (P<0.05).Univariate and Logistic multivariate regression analyses showed that SIGIRR≥80.45 pg/L, IL-1≥576.54 ng/L, Treg/Th17≥0.26, and NLR≥10.14 were all risk factors for predicting the prognosis of patients with secondary sepsis due to acute pancreatitis (P<0.05).The ROC curve showed that the AUC of SIGIRR was the highest (0.856, 95% CI 0.810-0.902), followed by Treg/Th17 (0.841, 95% CI 0.793-0.889), the combined AUC of the four indicators reached 0.886 (95% CI 0.828-0.931), which was significantly higher than that of any single indicator (Delong test, P<0.05), the sensitivity of the combined model was 84.4%and the specificity was 86.7%.

Conclusion

Peripheral blood SIGIRR, IL-1, Treg/Th17 and NLR are significantly correlated with the severity and prognosis of patients with secondary sepsis due to acute pancreatitis.The combined detection of the four indicators has excellent predictive efficacy.Meanwhile,monitoring is helpful to reflect clinical diagnosis and treatment as well as prognosis assessment.

Key words: Acute pancreatitis, Sepsis, Interleukin-1, Neutrophil/lymphocyte ratio, Single Ig interleukin-1-related receptor, Regulatory T cells/helper T cells 17 ratio

Hao Wang, Mi Huang, Xueqin Li. Correlation of SIGIRR, IL-1, Treg/Th17, NLR with severity and prognosis of acute pancreatitis secondary sepsis[J]. Chinese Journal of Digestion and Medical Imageology(Electronic Edition), 2025, 15(03): 250-255.

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URL: https://zhxhbyyxzz.cma-cmc.com.cn/EN/10.3877/cma.j.issn.2095-2015.2025.03.012

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Figures/Tables 5

临床资料	继发脓毒症组(n=56)	未继发脓毒症组(n=64)	对照组(n=50)	F/χ²	P
年龄(岁, $\overset{ˉ}{x}$ ± s )	45.86±13.62	45.74±14.56	45.55±14.47	0.145	0.525
性别(男/女,例)	30/26	39/25	28/22	0.233	0.656
体重指数(kg/m², $\overset{ˉ}{x}$ ± s)	24.43±2.12	24.54±3.58	24.62±3.55	2.422	0.451
SIGIRR(pg/L, $\overset{ˉ}{x}$ ± s )	83.66±23.62^ab	73.33±24.36^b	63.34±18.37	2.124	＜0.001
IL-1(ng/L, $\overset{ˉ}{x}$ ± s )	697.32±320.12 ^ab	526.28±217.40^b	386.60±117.45	3.320	＜0.001
Treg/Th17( $\overset{ˉ}{x}$ ± s )	0.38±0.14 ^ab	0.25±0.12^b	0.15±0.02	4.712	＜0.001
NLR( $\overset{ˉ}{x}$ ± s )	11.34±1.35 ^ab	9.47±1.33^b	7.58±1.17	8.210	＜0.001

临床资料	继发脓毒症组(n=56)	未继发脓毒症组(n=64)	对照组(n=50)	F/χ²	P
年龄(岁, $\overset{ˉ}{x}$ ± s )	45.86±13.62	45.74±14.56	45.55±14.47	0.145	0.525
性别(男/女,例)	30/26	39/25	28/22	0.233	0.656
体重指数(kg/m², $\overset{ˉ}{x}$ ± s)	24.43±2.12	24.54±3.58	24.62±3.55	2.422	0.451
SIGIRR(pg/L, $\overset{ˉ}{x}$ ± s )	83.66±23.62^ab	73.33±24.36^b	63.34±18.37	2.124	＜0.001
IL-1(ng/L, $\overset{ˉ}{x}$ ± s )	697.32±320.12 ^ab	526.28±217.40^b	386.60±117.45	3.320	＜0.001
Treg/Th17( $\overset{ˉ}{x}$ ± s )	0.38±0.14 ^ab	0.25±0.12^b	0.15±0.02	4.712	＜0.001
NLR( $\overset{ˉ}{x}$ ± s )	11.34±1.35 ^ab	9.47±1.33^b	7.58±1.17	8.210	＜0.001

临床资料	死亡组(n=34)	生存组(n=86)	t/χ²	P
年龄(岁, $\overset{ˉ}{x}$ ± s )	45.65±14.32	45.43±13.13	0.080	0.935
性别(男/女,例)	20/14	48/38	0.142	0.706
体重指数(kg/m², $\overset{ˉ}{x}$ ± s )	24.13±2.02	24.34±2.18	0.485	0.628
SIGIRR(pg/L, $\overset{ˉ}{x}$ ± s )	84.59±23.24	75.40±22.26	2.012	0.046
IL-1(ng/L, $\overset{ˉ}{x}$ ± s )	688.54±319.32	528.29±221.45	3.130	0.002
Treg/Th17( $\overset{ˉ}{x}$ ± s )	0.39±0.20	0.23±0.15	4.771	＜0.001
NLR( $\overset{ˉ}{x}$ ± s )	11.24±1.21	9.31±1.13	8.263	＜0.001

临床资料	死亡组(n=34)	生存组(n=86)	t/χ²	P
年龄(岁, $\overset{ˉ}{x}$ ± s )	45.65±14.32	45.43±13.13	0.080	0.935
性别(男/女,例)	20/14	48/38	0.142	0.706
体重指数(kg/m², $\overset{ˉ}{x}$ ± s )	24.13±2.02	24.34±2.18	0.485	0.628
SIGIRR(pg/L, $\overset{ˉ}{x}$ ± s )	84.59±23.24	75.40±22.26	2.012	0.046
IL-1(ng/L, $\overset{ˉ}{x}$ ± s )	688.54±319.32	528.29±221.45	3.130	0.002
Treg/Th17( $\overset{ˉ}{x}$ ± s )	0.39±0.20	0.23±0.15	4.771	＜0.001
NLR( $\overset{ˉ}{x}$ ± s )	11.24±1.21	9.31±1.13	8.263	＜0.001

变量	单因素Logistic		多因素Logistic
变量	OR(95% CI)	P	OR(95% CI)	P
年龄	1.003(0.978～1.029)	0.935
性别	1.131(0.524～2.441)	0.706
体重指数	0.961(0.822～1.124)	0.628
SIGIRR	3.124(1.851～5.263)	＜0.001	2.455(1.423～4.235)	0.001
IL-1	4.054(2.382～6.893)	＜0.001	3.303(1.883～5.804)	＜0.001
Treg/Th17	2.785(1.655～4.684)	＜0.001	2.152(1.254～3.706)	0.006
NLR	5.206(3.024～8.956)	＜0.001	4.104(2.302～7.326)	＜0.001

危险因素	截断值	AUC	95% CI	敏感度(%)	特异度(%)
SIGIRR	80.45 pg/L	0.856	0.810～0.902	78.2	82.5
IL-1	576.54 ng/L	0.826	0.776～0.876	75.6	80.3
Treg/Th17	0.26	0.841	0.793～0.889	77.1	81.8
NLR	10.14	0.828	0.778～0.878	76.3	79.5
联合	-	0.886	0.828～0.931	84.4	86.7

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