摘要
目的:探讨血清超敏C反应蛋白(hs-CRP)、降钙素原(PCT)、红细胞分布宽度(RDW)和有核红细胞(NRBC)水平在重症急性胰腺炎(SAP)患者中的表达水平及临床意义。方法:回顾性分析2021年1月至2022年12月在我院进行治疗的409例急性胰腺炎(AP)患者临床资料,依据病情严重程度分为轻度AP(MAP)组213例中度AP(MSAP)88例组与重度AP(SAP)组108例,对比三组血清hs-CRP、PCT、RDW、NRBC水平及急性生理及慢性健康(APACHE-Ⅱ)、急性胰腺炎CT严重程度指数(CTSI)评分,绘制hs-CRP、PCT、RDW、NRBC对SAP诊断价值的受试者工作特征曲线(ROC),分析其曲线下面积(AUC)。SAP组依据其临床结局分为生存组与死亡组,比较两组血清hs-CRP、PCT、RDW、NRBC水平及APACHE-Ⅱ评分;使用Preason相关性分析血清hs-CRP、PCT、RDW、NRBC水平与APACHE-Ⅱ评分相关性。结果:较MAP、MSAP组,SAP组血清hs-CRP、PCT、RDW、NRBC水平、APACHE-Ⅱ及CTSI评分更高,差异具有统计学意义(P<0.05)。绘制血清hs-CRP、PCT、RDW、NRBC对SAP预测价值的ROC曲线,结果显示hs-CRP、PCT、RDW、NRBC对SAP均具有诊断价值,其中PCT对SAP诊断效能最高(AUC=0.994),RDW对SAP诊断效能最低(AUC=0.772)。生存组血清hs-CRP、PCT、RDW、NRBC水平及APACHE-Ⅱ评分均低于死亡组,差异具有统计学意义(P<0.05)。Pearson相关性分析显示血清hs-CRP、PCT、RDW、NRBC与APACHE-Ⅱ评分呈正相关。结论:SAP患者血清hs-CRP、PCT、RDW和NRBC表达水平较高,与患者病情严重程度密切相关,检测血清hs-CRP、PCT、RDW和NRBC水平有助于判断SAP,可作为临床治疗SAP患者的实时监测指标。
Objective:To investigate the expression levels and clinical significance of serum hypersensitive C-reactive protein(hs-CRP),procalcitonin(PCT),red blood cell distribution width(RDW)and nucleated red blood cells(NRBC)in patients with severe acute pancreatitis(SAP).Methods:The clinical data of 409 patients with acute pancreatitis(AP)treated in our hospital from January 2021 to December 2022 were analyzed retrospectively.According to disease severity,the patients were divided into mild AP(MAP)group(213 cases),moderate AP(MSAP)group(88 cases)and severe AP(SAP)group(108 cases).Serum hs-CRP,PCT,RDW and NRBC levels,the Acute Physiological and Chronic Health Evaluation II(APACHE-II)scores and CT Severity Index(CTSI)scores were compared among the three groups.The receiver operating characteristic(ROC)curves of hs-CRP,PCT,RDW and NRBC for diagnosing SAP were plotted,and the area under the curve(AUC)was analyzed.According to clinical outcomes,patients in SAP group were divided into survival group and death group,serum hs-CRP,PCT,RDW and NRBC levels,and APACHE-II scores were compared between the two groups.The correlation between serum hs-CRP,PCT,RDW and NRBC levels and APACHE-II score was analyzed by Preason correlation analysis.Results:Compared with MAP group and MSAP group,serum hs-CRP,PCT,RDW and NRBC levels,APACHE-II scores and CTSI scores were higher in SAP group(P<0.05).The ROC curve analysis results showed that hs-CRP,PCT,RDW and NRBC were helpful for diagnosing SAP.Among them,the diagnostic efficiency of PCT was the highest(AUC=0.994),and the diagnostic efficiency of RDW was the lowest(AUC=0.772).Serum hs-CRP,PCT,RDW and NRBC levels,and APACHE-II scores in the survival group were lower than those in the death group(P<0.05).Pearson correlation analysis showed that serum hs-CRP,PCT,RDW and NRBC levels were positively correlated with APACHE-II score.Conclusion:Serum hs-CRP,PCT,RDW and NRBC levels are higher in patients with SAP,and are closely related to disease severity.The detection of serum hs-CRP,PCT,RDW and NRBC is beneficial to diagnose SAP,which indicates that these indicators can be used as real-time monitoring indicators for patients with SAP.
作者
李歌
田霞
LI Ge;TIAN Xia(Wuhan Third Hospital,Hubei Wuhan 430062,China)
出处
《河北医学》
CAS
2023年第5期762-767,共6页
Hebei Medicine
基金
湖北省卫生健康委员会课题,(编号:WJ2023M129)。
关键词
重症急性胰腺炎
超敏C反应蛋白
降钙素原
红细胞分布宽度
有核红细胞
Severe acute pancreatitis
Hypersensitive C-reactive protein
Procalcitonin
Red blood cell distribution width
Nucleated red blood cell
