血细胞比容变化对重症急性胰腺炎的诊断意义

Diagnostic value of the change of hematocrit for severe acute pancreatitis

目的 探讨血细胞比容（hematocrit，HCT）变化对重症急性胰腺炎（Severe acute pancreatitis。SAP）的预测价值及治疗意义。方法 收集我院2003-10-2006-09收治的急性胰腺炎（AP）住院患者210例，回顾分析了入院时（0d）及入院后1、3、7及14dHCT值，采用入院时男性HCT〉43．O％、女性HCT〉39.6％作为SAP的判断指标。结果 SAP组入院时HCT值高于非SAP组，其平均值分别为43．88％和39．12％，差异具有统计学意义（P〈Q05）。入院时HCT值判断SAP的敏感性、特异性、阳性预测值、阴性预测值分别为63．41％、65．09％、30．59％、88．00％。HCT值在入院时及入院后1d明显增高，随着治疗逐渐降低，到14d略增高趋于稳定。结论 简便易得的HCT值可作为SAP的早期识别指标，具有较高的阴性预测值；动态监测HCT值有助于判断病情、调整治疗。

Objective To study the predictive value of early change of hematocrit（HCT）for severe acute pancreatitis（SAP）. Methods A retrospective cohort study of 210 patients with acute pancreatitis admitted into our hospital from 2003- 2006 was carried out. The HCT at admission, at 1, 3 d, 7 and 14 day after admission were analysed. HCT〉43.0% for male and 〉39.6% for female at admission was used as an early marker for severe pancreatitis. Results HCT at admission of severe pancreatitis （ the metal was 43.88%） was higher than that of mild pancreatitis （ the mean was 39. 12%） （ P 〈 0.05）. The sensitivity, specificity, the pos- itive predictive value and negative predictive value of the HCT to diagnose severe pancreatitis were 63.41%, 65.09%, 30. 59% and 88.00%, respectively. HCT at admission and 1 day after admission increased obviously, decreased gradually with the treatment and stabilized after 14 days. Conclusion Initial HCT appears to be early, simple and useful predictor of severe pancreatitis, which has high negative predictive value. Monitoring the changes of HCT may contribute to the evaluation of the state of illness and the regulation of the treatment.