MCTSI联合D-D评估急性胰腺炎患者临床预后的可行性分析

Feasibility Analysis of MCTSI Combined with D-dimmer in Evaluating the Clinical Prognosis of Patients with Acute Pancreatitis

目的:评估MCTSI评分联合D-二聚体检测值与急性胰腺炎患者临床预后的相关性。方法:收集我院2016年8月至2018年1月间收治并确诊的急性胰腺炎患者150例,记录入院后首日血浆D-二聚体检测值,并于第5～7日行CT增强扫描检查,根据MCTSI标准进行评分,将MCTSI评分和血浆D-二聚体检测值经过Logistic回归方程得出联合检测值,并将MCTSI评分、D-二聚体检测值、联合检测值进行ROC曲线分析。结果:轻、中、重度急性胰腺炎患者血浆D-二聚体检测值及预后存在有明显差异(P <0.001),重度患者D-二聚体检测值显著高于轻、中度患者(P <0.001)。MCTSI评分和血浆D-二聚体检测值经过Logistic回归方程得出联合检测值对于患者器官功能衰竭预测的效能优于单独使用MCTSI评分及血浆D-二聚体检测值预测的效能,且其与住院天数的相关系数也最高。结论:针对急性胰腺炎患者,参照MCTSI以及D-二聚体检测值进行联合评估,可了解患者预后情况,具备较高的临床参考价值。

Objective:Assessing the correlation between MCTSI score combined with D-dimer detection value and the clinical prognosis in patients with acute pancreatitis.Methods:150 acute pancreatitis patients admitted to our hospital from August 2016 to January 2018 were collected.The plasma D-dimer detection value was recorded on the first day after admission.The CT enhancement scan was performed on the 5 th to 7 th day.According to the MCTSI standard,the combined detection value of MCTSI score and plasma D-dimer detection value was obtained by Logistic regression equation.MCTSI score,D-dimer detection value and combined detection value were analyzed by ROC curve.Results:There were significant differences in plasma D-dimer detection value and clinical prognosis among mild,moderate and severe acute pancreatitis patients(P < 0.001).The D-dimer detection value in severe patients was significantly higher than that in mild and moderate patients(P < 0.001).The combined detection value of MCTSI score and plasma D-dimer detection value obtained by Logistic regression equation is more effective in predicting organ failure than using MCTSI score and plasma D-dimer detection value alone,and it has the highest correlation coefficient with the length of hospital stay.MCTSI score combined with D-dimer detection value has high clinical reference value for clinical prognosis of acute pancreatitis patients.Conclusion:According to the combined evaluation of MCTSI and D-dimer detection value,we can understand the clinical prognosis of acute pancreatitis patients,which has a high clinical reference value.