红细胞分布宽度联合PCT对胰腺炎合并重症感染患者病情的评估

Effect of detection of red blood cell distribution width combined with PCT on patients with severe pancreatitis and severe infections

目的探讨联合检测红细胞分布宽度(RWD)和降钙素原(PCT)对于急性胰腺炎(AP)合并重症感染患者病情评估的效果,为临床治疗提供参考依据。方法选取2012年6月-2016年1月于医院就诊的急性胰腺炎患者122例,按疾病程度分为轻症急性胰腺炎(MAP)组68例和急性胰腺炎合并严重感染者(SAP)组54例,比较两组患者入院24h后临床指标。结果 SAP组PCT、RDW、超敏C-反应蛋白(hs-CRP)、肿瘤坏死因子-α(TNF-α)、白介素-8(IL-8)和急性生理及慢性健康(APACHEⅡ)评分均显著高于MAP组,差异均有统计学意义(P<0.05);SAP组54例患者中,最终11例死亡,病死率为20.4%;死亡患者PCT、RDW、hs-CRP、TNF-α、IL-8和APACHEⅡ评分均显著高于存活患者,差异均有统计学意义(P<0.05);SPearman相关性分析结果显示,PCT、RDW、hs-CRP、TNF-α和IL-8与APACHEⅡ评分均存在显著正相关性。结论联合检测红细胞体积分布宽度和降钙素原对于胰腺炎合并重症感染患者病情评估和预后判断具有重要意义,具有快速、简单、费用低廉的特点,可以考虑作为临床治疗胰腺炎合并重症感染患者的实时监测指标。

OBJECTIVE To evaluate the efficacy of combined detection of red blood cell distribution width（RWD）and procalcitonin（PCT）in patients with acute pancreatitis（AP）and severe infections,so as to provide references for clinical treatment.METHODS A total of 122 patients with acute pancreatitis admitted in our hospital from Jun.2012 to Jan.2016 were selected.Patients were divided into mild acute pancreatitis（MAP）group（n=68）and severe acute pancreatitis（SAP）group（n=54）according to the severity of the disease.The clinical indexes of the two groups of patients were measured after 24 hours of hospitalization.RESULTS The levels of PCT,RDW,highsensitivity C-reactive protein（hs-CRP）,tumor necrosis factor-α（TNF-α）,interleukin-8（IL-8）and acute physiology and chronic health（APACHE Ⅱ）score in SAP group were significantly higher than those in MAP group.In SAP group,11 cases died,with the mortality of 20.4%.The levels of PCT,RDW,hs-CRP,TNF-α,IL-8and APACHEⅡ score in death group were significantly higher than those in survivors group（P〈0.05）.Spearman correlation analysis showed that PCT,RDW,hs-CRP,TNF-αand IL-8were positively correlated with APACHEⅡ.CONCLUSIONThe combined detection of red blood cell volume distribution width and procalcitonin is of great significance for the evaluation and prognosis of acute pancreatitis,which is rapid,simple and inexpensive.It can be considered as a specific index for clinical treatment of acute pancreatitis.