摘要
目的探究降钙素原/白蛋白(PCT/Alb)比值联合残余胆固醇/高密度脂蛋白胆固醇(RC/HDL-C)比值对急性胰腺炎(AP)患者病情及预后的评估价值。方法选择2018年9月至2024年9月聊城市第二人民医院收治的134例AP患者作为研究对象。根据病情严重程度,将患者分为轻症(MAP)组(n=98)和重症(SAP)组(n=36),比较2组的PCT/Alb比值和RC/HDL-C比值。所有患者自入院后随访28 d,根据预后情况将患者分为预后良好组和预后不良组,比较2组的PCT/Alb比值、RC/HDL-C比值及一般资料。采用多因素logistic回归模型分析AP患者预后的影响因素。采用ROC曲线分析PCT/Alb比值、RC/HDL-C比值对AP患者预后的评估价值。结果与MAP组相比,SAP组的PCT/Alb比值、RC/HDL-C比值均显著升高,差异均有统计学意义(P均<0.05)。随访结果显示,134例AP患者中有21例预后不良(设为预后不良组),其余113例设为预后良好组。与预后良好组相比,预后不良组的PCT/Alb比值、RC/HDL-C比值均显著升高,差异均有统计学意义(P均<0.05)。多因素logistic回归模型分析结果显示,急性生理学与慢性健康状况评价Ⅱ(APACHEⅡ)评分、胰腺坏死范围、PCT/Alb比值和RC/HDL-C比值均是AP患者预后的独立危险因素(P均<0.05)。ROC曲线分析结果显示,PCT/Alb比值联合RC/HDL-C比值预测AP患者预后不良的曲线下面积(AUC)分别大于PCT/Alb比值、RC/HDL-C比值单独预测(Z=2.315,P=0.043;Z=3.109,P=0.002)。结论PCT/Alb比值和RC/HDL-C比值均与AP患者病情严重程度密切相关,且均是AP患者预后的独立危险因素,两者联合评估对于AP患者预后预测具有一定应用价值。
Objective This paper is to explore the value of procalcitonin(PCT)/albumin(Alb)ratio combined with residual cholesterol(RC)/high-density lipoprotein cholesterol(HDL-C)ratio in the assessment of the condition and prognosis of patients with acute pancreatitis(AP).Methods One hundred and thirty-four AP patients admitted to the Second People's Hospital of Liaocheng from September 2018 to September 2024 were selected and divided into the mild(MAP)group(n=98)and the severe(SAP)group(n=36)based on the severity of the disease.The PCT/Alb ratio and RC/HDL-C ratio of the two groups were compared.They were followed up for 28 days after admission.Based on the prognosis,the patients were further divided into the good prognosis group and the poor prognosis group.The PCT/Alb ratio,RC/HDL-C ratio,and general data of the two groups were compared.The influencing factors of prognosis in patients with AP were analyzed by multifactor logistic regression model.The evaluation value of PCT/Alb and RC/HDL-C in the prognosis of AP patients was analyzed using the ROC curve.Results Compared with the MAP group,the ratios of PCT/Alb and RC/HDL-C in the SAP group are significantly higher,with statistically significant differences(P<0.05).Follow-up results show that among the 134 patients with AP,21 patients have poor prognosis(the poor prognosis group)and the remaining 113 patients are the good prognosis group.Compared with the good prognosis group,the ratios of PCT/Alb and RC/HDL-C in the poor prognosis group are significantly higher,with statistically significant differences(P<0.05).Multivariate logistic regression model analysis shows that APACHEⅡscore,pancreatic necrosis range,PCT/Alb and RC/HDL-C are independent risk factors for prognosis in AP patients(P<0.05).ROC curve analysis shows that the area under the curve(AUC)of PCT/Alb and RC/HDL-C combined detection in predicting poor prognosis of AP patients is larger than PCT/Alb and RC/HDL-C alone detection(Z=2.315,P=0.043;Z=3.109,P=0.002).Conclusion PCT/Alb and RC/HDL-C are closely related to the severity of AP,both of which are independent risk factors for prognosis of AP patients,and their combined detection has certain application value for prognosis evaluation of AP patients.
作者
谢华磊
张贵志
潘凌云
孔令甲
田之雷
乌列强
魏嘉宁
XIE Hualei;ZHANG Guizhi;PAN Lingyun;KONG Lingjia;TIAN Zhilei;WU Lieqiang;WEI Jianing(Department of Emergency,the Second People's Hospital of Liaocheng,Liaocheng 252600,China;Department of Gastroenterology,the Second People's Hospital of Liaocheng,Liaocheng 252600,China)
出处
《国际消化病杂志》
2025年第4期279-284,共6页
International Journal of Digestive Diseases
关键词
急性胰腺炎
降钙素原
白蛋白
残余胆固醇
高密度脂蛋白胆固醇
Acute pancreatitis
Procalcitonin
Albumin
Residual cholesterol
High-density lipoprotein cholesterol
