摘要
目的探讨床旁急性胰腺炎严重度(BISAP)评分联合红细胞体积分布宽度(RDW)/Ca^(2+)对早期急性胰腺炎(AP)患者病情严重程度的预测价值。方法回顾性分析2019年6月—2022年10月我院收治的142例早期AP患者的临床资料,根据病情严重程度分为轻症AP组(MAP组,n=87)、中度重症AP组(MSAP组,n=31)和重症AP组(SAP组,n=24),患者入院24 h内进行血常规、血钙检查并进行BISAP评分,比较3组一般资料、血常规[红细胞计数(RBC)、白细胞计数(WBC)、白蛋白(ALB)、RDW、中性粒细胞计数、淋巴细胞计数]、肾功能指标[尿素氮(BUN)、血肌酐(Scr)、血Ca^(2+)]、肝功能指标[谷草转氨酶(AST)、谷丙转氨酶(ALT)、]、心肌功能指标[乳酸脱氢酶(LDH)]、血性炎症因子[C反应蛋白(CRP)],并计算中性粒细胞淋巴细胞比值(NLR)、RDW/Ca^(2+),评估入院BISAP评分。采用多因素Logistic回归分析影响早期AP病情的危险因素,通过受试者工作特征(ROC)曲线评估BISAP评分、RDW/Ca^(2+)单独及联合诊断早期AP病情严重程度的价值。结果3组一般临床资料比较,差异无统计学意义(P>0.05);3组血清CRP、Scr、LDH、Ca^(2+)、NLR、RDW、RDW/Ca^(2+)、BISAP评分比较,差异有统计学意义(P<0.05),血WBC、RBC、ALB、BUN、AST、ALT比较,差异无统计学意义(P>0.05);多因素Logistic回归分析显示,血清CRP、NLR、RDW、血Ca^(2+)、RDW/Ca^(2+)、BISAP评分是影响早期AP患者病情严重程度的危险因素(P<0.05);ROC曲线分析显示,BISAP评分、RDW/Ca^(2+)单独及联合预测早期AP患者病情严重程度的AUC分别为0.835、0.829、0.917,敏感度分别为81.82%、78.16%、87.27%,特异度分别为68.97%、74.71%、75.86%,联合诊断价值较高。结论BISAP评分和RDW/Ca^(2+)检测可预测早期AP患者病情严重程度和预后,联合预测价值更高。
Objective To explore the predictive value of bedsideindexfor severity in acute pancreatitis(BISAP)score combined with red blood cell volume distribution width(RDW)/Ca^(2+)on the disease severity in patients with early acute pancreatitis(AP).Methods The clinical data of 142 patients with early AP in the hospital were retrospectively analyzed.According to the severity of disease,the patients were divided into mild AP(MAP)group(n=87),moderate-to-severe AP(MSAP)group(n=31)and severe AP(SAP)group(n=24).Blood routine examination,blood calcium examination and BISAP score were performed within 24 hours after admission.The general data were compared among the three groups,and multivariate Logistic regression analysis was used to analyze the risk factors affecting the severity of early AP.Receiver operating characteristic(ROC)curve was applied to evaluate the value of BISAP score and RDW/Ca^(2+)alone and in combination in diagnosing the severity of early AP.Results There were no statistical differences in general clinical data among the three groups(P>0.05).There were statistically significant differences in serum CRP,Scr,LDH,Ca^(2+),NLR,RDW,RDW/Ca^(2+)and BISAP score among the three groups(P<0.05),but there were no statisticaldifferences in white blood cell,red blood cell,ALB,BUN,AST and ALT(P>0.05).Multivariate Logistic regression analysis showed that serum CRP,NLR,RDW,blood Ca^(2+),RDW/Ca^(2+)and BISAP score were risk factors for the severity of patients with early AP(P<0.05).ROC curve analysis revealed that the AUCs of BISAP score,RDW/Ca^(2+)alone and in combination for predicting the severity of patients with early APwere 0.835,0.829 and 0.917 respectively,and the sensitivities were 81.82%,78.16%and 87.27%and the specificities were 68.97%,74.71%and 75.86%respectively.Combined diagnosis had high value.Conclusion BISAP score combined with RDW/Ca^(2+)detection can predict the severity and prognosis of patients with early AP,and the combined diagnosis has highpredictive value.
作者
樊斌
李庆贺
李伟
张家耀
丁俊
FAN Bin;LI Qinghe;LI Wei;ZHANG Jiayao;DING Jun(Department of Hepatobiliary Surgery,Enshi Tujia and Miao Autonomous Prefecture Central Hospital,Enshi 445000,Hubei,China;Department of Pathology,Enshi Tujia and Miao Autonomous Prefecture Central Hospital,Enshi 445000,Hubei,China)
出处
《西部医学》
2024年第11期1697-1701,共5页
Medical Journal of West China
基金
湖北省卫健委科研项目(WJ2021F092)。
关键词
床旁急性胰腺炎严重度评分
红细胞体积分布宽度
血钙
急性胰腺炎
诊断价值
Bedsideindexfor severity in acute pancreatitis
Red blood cell volume distribution width
Blood calcium
Acute pancreatitis
Diagnostic value
