摘要
目的探讨血清C反应蛋白与白蛋白(CRP/ALB)比值、乳酸脱氢酶(LDH)与血钙联合检测对早期急性胰腺炎严重程度的预测价值。方法选取138例2018.07-2021.06期间于安徽医科大学第一附属医院住院治疗的急性胰腺炎患者资料。将患者分为(1)MAP及MSAP组(n=100),(2)SAP组(n=38),共两组。通过单因素分析筛选出与早期AP严重程度相关的指标,再通过多因素分析Logistic回归将独立危险因素筛出。对筛选出的独立因素采用受试者工作特征曲线分析其预测效能。结果(1)SAP组中心率、呼吸、CRP、HCT、D-二聚体、PCT、血淀粉酶、血肌酐、AST、总胆红素、LDH、ALB、CRP/ALB比值较MAP+MSAP组显著增高,ALP轻度降低,血钙显著降低,差异具有统计学意义(P<0.05)。(2)LDH(OR=1.002,95%CI:1.001~1.003)、血钙(OR=0.134,95%CI:0.027~0.676)、CRP/ALB比值(OR=1.727,95%CI:1.291~2.310)是发生SAP的独立危险因素(P<0.05)。(3)CRP/ALB比值、LDH、血钙联合检测预测早期AP严重程度分层的价值最高。结论CRP/ALB比值、LDH、血钙三者联合检测对早期AP严重程度分层具有较高的预测价值。
Objective To investigate the predictive value of the combined detection of CRP/ALB ratio,lactate dehydrogenase(LDH)and serum calcium for the severity of early AP.Methods The date of 138 patients with AP admittedto the First Affiliated Hospital of AHMU from July 2018 to June 2021 were selected.Patients were divided into two groups:(1)the group of MAP combined with MSAP,n=100;(2)the group of SAP,n=38.The single-factor was used to screen out the factors related to the severity of early AP,and the independent risk factors were screen out by the multi-factor analysis logistic regression.To evaluate the predictive value by the receiver operating characteristic.Results(1)Compared with the group of MAP combined with MSAP,the heart rate,respiratory rate,CRP,HCT,D-dimer,PCT,serum amylase,serum creatinine,AST,total bilirubin,LDH,ALB and CRP/ALB ratio in SAP group were significantly increased,ALP was slightly decreased,and serum calcium was significantly decreased(P<0.05).(2)LDH(OR=1.002,95%CI:1.001~1.003),serum calcium(OR=0.134,95%CI:0.027~0.676),and CRP/ALB ratio(OR=1.727,95%CI:1.291~2.310)were independent risk factors for SAP(P<0.05).(3)The combined detection of CRP/ALB ratio,LDH and serum calcium had the highest value in predicting the stratification of the severity of early AP.Conclusion The combined detection of CRP/ALB ratio,LDH and serum calcium has high predictive value for the classification of the severity of early AP.
作者
张同远
张忆
陈卫东
张剑林
王兴宇
ZHANG Tong⁃yuan;ZHANG Yi;CHEN Wei⁃dong(Department of Emergency Surgery,The First Affiliated Hospital of Anhui Medical University,Hefei 230022,China;The Fifth College of Clinical Medicine ofXinjiang Medical University)
出处
《肝胆外科杂志》
2022年第4期266-271,共6页
Journal of Hepatobiliary Surgery
