早期红细胞压积、血糖变化对老年重症急性胰腺炎早期识别的临床价值

The Clinical Value of the Hematocrit and Blood Glucose as Early Marker of the Older Patients with Severe Acute Panceatitis

目的评估红细胞压积（HCT）、血糖变化对老年重症急性胰腺炎早期识别的临床价值。方法回顾性分析因急性胰腺炎住院治疗的老年患者48例入院24小时内红细胞压积（HCT）、血糖数值,比较轻症胰腺炎（MAP,n=33例）和重症胰腺炎（SAP,n=15例）两组HCT、血糖的变化,并评估HCT、血糖与老年急性胰腺炎严重程度的相关性。结果SAP组HCT、血糖均较MAP组明显升高（P〈0.001）,AP病情严重程度与HCT、血糖变化呈正相关,Logistic回归分析表明血糖（χ2=157.79,P=0.000,OR=1.462,95%CI：1.342~1.593）和HCT（χ2=4.23,P=0.038,OR=4.008,95%CI：0.162~9.017）是SAP独立的危险性因素。结论早期HCT、血糖检测有助于早期识别老年重症急性胰腺炎,对判断老年急性胰腺炎的严重程度具有肯定的临床价值。

Objective To evaluate the clinical value of the hematocrlt （HCT）and blood glucose as early marker of the older patients with severe acute panceatitis. Methods Forty eight cases of the older patients with acute pancreatitis in our hospital were included in this study. The HCT and blood glucose within 24 hours after admission were evaluated retrospectively, and the diffirence between severe acute pancreatltls （SAP, n = 15 cases） and mild acute pancreatitls （MAP, n = 33 cases） were analyzed. The correlation between HCT and blood glucose, and the severity of the older patients with acute pancreatitis was evaluated. Results The level of hematocrlt and blood glucose in SAP group were signifi- cantly higher than those in MAP group（P〈0. 001）. The severity of acute pancretltis had positive correlation with hematocrit and blood glucose. The blood glucose level（χ^2= 157.79, P = 0. 000, OR = 1. 462,95 % CI ： 1. 342- 1. 593） and hematocrit （ χ^2 = 4.23, P = 0. 038, OR = 4. 008,95 % CI ： 0. 162 -9. 017）were independent risk factors of SAP by logistic regression analysis. Conclusion The early detection of hematocrit and blood glucose helpful to make to early diagnosis of the older patients with SAP and the definite value to evaluate the severity of acute pancreatitis in older patients.