血清白/球蛋白比值、乳酸脱氢酶及尿素氮与急性胰腺炎严重程度的相关性研究

Correlation between serum albumin/globulin ratio,lactate dehydrogenase,urea nitrogen and the severity of acute pancreatitis

目的探讨血清白/球蛋白比值(AGR)、乳酸脱氢酶(LDH)及尿素氮(BUN)与急性胰腺炎(AP)严重程度的相关性。方法纳入2017年10月~2019年10月我院收治的92例AP患者,按照2012年亚特兰大分类标准将其分为轻、中、重度3组,收集3组患者的临床资料[性别、年龄、WBC计数、血钙、肌酐、急性生理与慢性健康(APACHEⅡ)评分]、AGR、LDH及BUN水平并进行比较。采用Pearson相关分析探讨3组患者血清AGR、LDH及BUN水平与APACHEⅡ评分的相关性,采用受试者工作特征(ROC)曲线分析血清AGR、LDH及BUN单独应用及联合应用判断AP患者病情严重程度的价值。结果3组患者APACHEⅡ评分比较差异有统计学意义,其中中度组患者APACHEⅡ评分高于轻度组,重度组患者APACHEⅡ评分高于中度组(P<0.05)。3组患者血清AGR水平依次降低,LDH及BUN水平依次升高(P<0.05)。血清AGR与APACHEⅡ评分呈负相关(r=-0.723,P<0.05),LDH(r=0.743,P<0.05)及BUN(r=0.446,P<0.05)与APACHEⅡ评分呈正相关。各指标单独应用时,LDH诊断中、重度AP的效能最高,其次是AGR与BUN(P<0.01);联合应用以上3项指标检测能有效提高诊断效能(P<0.001)。结论血清AGR、LDH及BUN水平在评估AP患者病情严重程度中均具有良好应用价值,各指标单独应用中以LDH诊断效能最高,3项指标联合检测能有效提高诊断效能,应用价值更高。

Objective Explore the correlation between serum albumin/globulin ratio(AGR),lactate dehydrogenase(LDH),urea nitrogen(BUN)and the severity of acute pancreatitis(AP).Methods Ninety-two AP patients admitted to our hospital from October 2017 to October 2019 were divided into mild group,moderate group and severe group according to the Atlanta classification(2012).The clinical data[gender,age,WBC count,blood calcium,creatinine,acute physiology and chronic health evaluation(APACHEⅡ)score],AGR,LDH and BUN levels were collected and compared among the 3 groups.The correlation between the levels of AGR,LDH,BUN levels and APACHEⅡscore were also analyzed by Pearson correlation analysis.The receiver operator characteristic(ROC)curve was used to analyze the value of single detection and combined detection of AGR,LDH and BUN levels in the evaluating the severity of AP.Results APACHEⅡscore had significant difference among the 3 groups,in APACHEⅡscore,the moderate group patients was higher than that in the mild group,and it was higher in the severe group than that of moderate graup(P<0.05).Serum AGR level of mild group,moderate group and severe group showed a downward trend,while LDH and BUN showed an upward trend(P<0.05).Serum AGR was negatively correlated with APACHEⅡscore(r=-0.723,P<0.05),LDH(r=0.743,P<0.05)and BUN(r=0.446,P<0.05)were positively correlated with APACHEⅡscore.LDH in the single detection had the highest diagnostic efficacy for severe acute pancreatitis,followed by AGR and BUN(P<0.01),meanwhile,the combined detection of the 3 indicators could improve the diagnostic efficacy(P<0.001).Conclusion Serum AGR,LDH and BUN have high clinical value in evaluating the severity of AP.For the single detection,LDH has the highest diagnostic efficacy,while the combined detection of the 3 indicators has higher diagnostic efficacy and better application value.