血小板计数和持续全身炎症反应综合征预测急性胰腺炎并发多脏器功能不全的研究

Clinical usefulness of platelet counts and sustained systemic inflammatory response sysdrome predict acute pancreatis combined with multipe organ dysfunction syndrome

目的 评估血小板计数和持续全身炎症反应综合征 (SIRS)预测急性胰腺炎 (AP)并发多脏器功能不全综合征(MODS)的价值。方法 回顾性分析 15 2例AP病人的临床资料 ,按持续SIRS时间分为A组 (无SIRS发生 )、B组 (持续SIRS≤ 3天 )和C组 (持续SIRS >3天 ) ,比较各组血小板计数、MODS发生率和病死率 ,并描绘血小板计数预测AP并发MODS的ROC曲线。结果 入院 2 4小时内 3组病人的血小板计数有显著差异。SIRS >3天组病人的MODS发生率及病死率明显高于其他 2组。SIRS >3天和血小板计数 <80× 10 9/L预测AP并发MODS的似然比分别是 12 6 5和 5 2 9。血小板计数 ( 80× 10 9/L)预测MODS的敏感性和特异性分别为 88 89%和 83 2 %。结论 血小板计数和持续SIRS对预测AP并发MODS有较高的价值 。

Objective To determine the usefulness of platelet counts and sustained systemic inflammatory response sysdrome (SIRS) in predicting acute pancreatis (AP) combined with multipe organ dysfunction syndrome (MODS).Methods A retrospective analysis was made in 152 patients with acute pancreatis. These patients were divided into 3 groups according to the sustained SIRS:group A (non-SIRS), group B (sustained SIRS≤3 days) and group C (sustained SIRS>3 days). The platelet count, the incidence of MODS and the mortality rate were compared in every group. A receiver operating characteristic (ROC) curve of platelet counts for predicting AP combined with MODS was also constructed. Results Platelet counts showed significant differences among the three groups. The incidence of MODS and mortality rate was significantly higher in patients with SIRS for>3 days compared with those in the other groups. Likelihood ratios of platelet counts and SIRS for>3 days for predicting MODS were 5.29 and 12.65 respectively. Platelet counts(80×10 9/L) had a sensitivity of 88.89% and a sepcificity of 83.2% for predicting MODS. Conclusion Platelet counts and sustained SIRS are useful for predicting AP combined with MODS. Platelet counts can be used as a simple laboratory test for predicting MODS. [