甘油三酯、血糖、血小板平均体积水平在高脂血症性及非高脂血症性急性胰腺炎中的临床应用

Clinical Application Of Glucose,Triglycerides,Mean Platelet Volume In Hypertriglyceridemic Acute Pancreatitis And Non-hypertriglyceridemic Acute Pancreatitis

目的:比较甘油三酯(TG)、血糖(Glu)、血小板平均体积(MPV)水平在高脂血症性(hypertriglyceridemic acute pancreatitis, HLAP)和非高脂血症性急性胰腺炎(non-hypertriglyceridemic acute pancreatitis, NHLAP)之间的差异,提高对高脂血症性急性胰腺炎的认识,探讨三者能否作为鉴别以上两种类型胰腺炎的参考指标.方法:选择于2014年7月~2018年12月期间医院收治的高脂血症性急性胰腺炎患者51例为高脂血症组和非高脂血症性急性胰腺炎51例为非高脂血症组,使用全自动生化分析仪检测血清生化指标,使用全自动血液分析仪检测血常规指标,比较两组各指标间的差异,并采用受试者工作特征(ROC)曲线评价各指标对以上两种类型胰腺炎的鉴别诊断价值.结果:HLAP组的Glu、TG均高于NHLAP组,而TBIL、ALT、ALP、AMY、LPS、RDW、PLT明显低于NHLAP组,两组之间比较,差异有统计学意义(P<0.05);MPV、PDW差异无统计学意义(P>0.05). ROC曲线分析显示, Glu、TG以及MPV对鉴别HLAP和NHLAP有一定价值,根据最大约登指数, Glu以8.905mmol/L为截距点,对应点的灵敏度为68.6%、特异度为88.2%,ROC曲线下面积(AUC)为0.821(95%CI0.739~0.904);TG以5.695mmol/L为截距点,对应点的灵敏度为及特异度均为100%, ROC曲线下面积(AUC)为1(95%CI1~1);MPV以10fL为截距点,对应点的灵敏度为54.9、特异度为74.5%, ROC曲线下面积(AUC)为0.633(95%CI0.524~0.742).结论:TG是鉴别HLAP和NHLAP的可靠指标, Glu用于鉴别HLAP及NHLAP具有良好的参考性, MPV用于鉴别HLAP及NHLAP具有良好的特异性,但灵敏度较低.

Objective: To compare the differences of glucose,triglycerides,and mean platelet volume between patients with hyperlipidemia (HLAP) and non-hyperlipidemia acute pancreatitis (NHLAP),so as to understanding well of hypertriglyceridemic acute pancreatitis and exploring whether this indexes can be used to identify the etiology of acute pancreatitis. Methods: A total of 51 patients with hyperlipidemic acute pancreatitis were selected as hyperlipidemia group and 51 patients with non-hyperlipidemic acute pancreatitis were selected as non-hyperlipidemia group from 2014 to 2018, Serum biochemical indexes were detected by the automatic biochemical analyzer, and blood routine indexes were detected by the automatic blood analyzer. The differences between the two groups were compared, and the value of each index in the differential diagnosis of the two types of pancreatitis was evaluated by the ROC curve. Results: the Glu and TG of HLAP group were higher than those of NHLAP group, while the TBIL, ALT, ALP, AMY, LPS, RDW and PLT of HLAP group were significantly lower than those of NHLAP group (P<0.05). There was no significant difference in MPV and PDW (P>0.05). ROC curve analysis showed that Glu, TG and MPV were of certain value in identifying HLAP and NHLAP. According to the most approximate index, the intercept point of Glu was 8.905mmol/L, the sensitivity and specificity of the corresponding point were 68.6% and 88.2%, and the area under the ROC curve (AUC) was 0.821 (95%CI 0.739~0.904). TG takes 5.695mmol/L as the intercept point, the sensitivity and specificity of corresponding points are both 100%, and the area under the ROC curve (AUC) is 1 (95%CI 1-1). The sensitivity and specificity of MPV at 10fL were 54.9 and 74.5, and the area under the ROC curve (AUC) was 0.633 (95%CI 0.524~0.742). Conclusion: TG is a reliable index to distinguish HLAP from NHLAP Glu has a good reference for identifying HLAP and NHLAP. High specificity but low sensitivity MPV were found for identifying HLAP and NHLAP.