平均血小板体积对急性胰腺炎患者病因鉴别诊断的可行性研究

Feasibility study on the differential diagnosis of mean platelet volume on the etiology of patients with acute pancreatitis

目的探讨平均血小板体积(MPV)可否作为急性胰腺炎患者病因的鉴别指标。方法选取本院2016年11月至2017年11月收治的急性胰腺炎患者111例,其中非胆源性胰腺炎患者58例作为非胆源性组,胆源性胰腺炎患者53例为胆源性组。对比两组患者生化指标(CREA、AST、GGT等)、血液学指标(白细胞计数、MPV、血红蛋白、血细胞压积、血小板计数),受试者工作特征曲线分析MPV对两组患者的鉴别作用,分析MPV与两组患者各项指标之间的关系。结果两组患者CREA、GLU、LPS、Ca、AMY差异无统计学意义(P>0.05);胆源性组患者AST、GGT、ALP、ALT、DBIL、TBIL均高于非胆源性组,差异有统计学意义(P<0.05)。两组患者白细胞计数、血红蛋白、血细胞压积差异无统计学意义(P>0.05);胆源性组患者MPV较非胆源性组高,血小板计数较非胆源性组低,差异均有统计学意义(P<0.05)。MPV在鉴别两组ROC曲线下面积为0.745(95%CI:0.861~0.993);当8.32为MPV的cut-off值时,可鉴别胆源性组的特异度和敏感度分别为62.1%、78.5%。两组患者白细胞计数、血红蛋白、CREA、ALP、ALT、GLU、LPS、GGT、DBIL、Ca、TBIL与MPV水平无相关性;非胆源性组AST与MPV呈负相关性(r=-0.271,P=0.022);胆源性组患者AMY与MPV呈正相关性(r=0.282,P=0.017)。结论临床可将平均血小板体积作为非胆源性和胆源性急性胰腺炎的鉴别指标,为急性胰腺炎的鉴别和治疗提供一定依据。

Objective To explore whether the mean platelet volume(MPV) can be used as a clinical indicator of the etiology of acute pancreatitis. Methods A total of 111 patients with acute pancreatitis who were admitted to our hospital from November 2016 to November 2017 were selected. Among them, 58 cases of non biliary pancreatitis were non biliary origin group, and 53 cases of biliary pancreatitis were biliary origin group. The two groups of patients biochemical indicators(CREA, AST, GGT, etc.), hematological parameters(white blood cell count, MPV, hemoglobin, hematocrit, platelet count) were compared, the subject’s work curve analyzed the role of MPV in the two groups of patients, the relationship between MPV and the indicators of the two groups of patients was analyzed. Results There was no significant difference in CREA, GLU, LPS, Ca and AMY between the two groups(P>0.05). The levels of AST, GGT, ALP, ALT, DBIL and TBIL in the biliary origin group were significantly higher than those in the non biliary origin group, the difference was statistically significant(P<0.05). There was no significant difference in white blood cell count, hemoglobin and hematocrit between the two groups(P>0.05). The MPV in the biliary origin group was higher than that in the non biliary origin group, and the platelet count in the biliary origin group was lower than that in the non biliary origin group, and the difference was statistically significant(P<0.05). The area of MPV in the identification of two groups of ROC curves was 0.745(95%CI:0.861-0.993). When 8.32 was the cut-off value of MPV, the specificity and sensitivity of the differentiated biliary origin group were 62.1% and 78.5% respectively. There was no correlation between white blood cell count, hemoglobin, CREA, ALP, ALT, GLU, LPS, GGT, DBIL, Ca, TBIL and MPV level in the two groups of patients. There was a negative correlation between AST and MPV in non biliary origin group(r=-0.271, P=0.022), and there was a positive correlation between AMY and MPV in biliary origin group(r=0.282, P=0.017). Conclusion The average platelet volume can be used clinically as a differential marker for non-biliary and biliary acute pancreatitis, providing a basis for the identification and treatment of acute pancreatitis.