红细胞分布宽度/血清钙离子对急性胰腺炎严重程度的早期诊断价值

The value of red cell distribution width to serum calcium ratio in early diagnosis of acute pancreatitis

目的探讨红细胞分布宽度(RDW)与血清钙离子(SC)比值(RDW/SC)对急性胰腺炎(AP严重程度的早期诊断价值。方法回顾分析广西医科大学第二附属医院和广西医科大学第一附属医院自2013年1月1日至2018年12月31日住院的AP患者228例,其中轻症急性胰腺炎组(MAP)169例,重症急性胰腺炎组(SAP)59例。比较两组患者的一般资料、生化指标以及多种AP预测评分系统之间的差异,应用ROC曲线评估早期AP患者中RDW/SC与RDW、SC以及多种AP预测评分系统之间的敏感性和特异度。结果SAP组患者中RDW/SC明显高于MAP组患者[(7.8±1.6)vs(6.0±0.6),P<0.001]。ROC曲线分析显示,RDW/SC的敏感性为79.3%,特异度为89.2%,ROC曲线下面积(AUROC)为0.913(95%CI:0.869~0.946),优于RDW(AUROC 0.753,95%CI:0.692~0.808,P<0.001)和SC(AUROC 0.870,95%CI:0.819~0.910,P<0.001)。另外,通过AUROC比较,RDW/SC与Ranson评分、BISAP评分、MCTSI评分系统之间无统计学差异(P>0.05)。结论RDW/SC有较高的敏感性和特异度,对SAP的早期识别价值更高,具有较好的临床应用前景。

Objective To investigate the early diagnostic value of the ratio of red cell distribution width(RDW)to serum calcium(SC)in acute pancreatitis.Methods A retrospective analysis was made of 228 patients with AP hospitalized in the second affiliated hospital of Guangxi Medical University and the first affiliated hospital of Guangxi Medical University from January 1 st 2013 to December 31 st 2018,including 169 patients with mild acute pancreatitis(MAP)and 59 patients with severe acute pancreatitis(SAP).The differences of general data and biochemistry indexes and various AP predictive scoring systems between the two groups were compared.Evaluation of sensitivity and specificity between RDW/SC,RDW,SC and multiple AP predictive scoring systems in early AP patients were deternmined by ROC curve.Results RDW/SC in SAP patients was significantly higher than that in MAP patients[(7.8±1.6)(6.0±0.6),P<0.001].ROC curve analysis showed that the sensitivity,specificity and AUROC of RDW/SC were 79.3%,89.2%and 0.913(95%CI 0.869~0.946),respectively,which were better than those of RDW(AUROC 0.753,95%CI:0.692~0.808,P<0.001)and SC(AUROC 0.870,95%CI:0.819~0.910,P<0.001).In addition,by AUROC comparison,there was no significant difference between RDW/SC and Ranson score,BISAP score and MCTSI score system(P>0.05).Conclusions RDW/SC has a higher value for early recognition of SAP and has a good prospect of clinical application.