中性粒细胞与淋巴细胞比值、C-反应蛋白和血糖联合检测在急性胰腺炎诊断及预后中的应用价值

The combined detection value of NLR,CRP and GLU in the diagnosis and prognosis of acute pancreatitis

目的探讨中性粒细胞与淋巴细胞比值(NLR)、C-反应蛋白(CRP)和血糖(GLU)在急性胰腺炎诊断与预后中的应用价值。方法选取2018年6月-2019年5月该院收治的88例急性胰腺炎患者作为研究对象,设为观察组。取同期入院健康体检者80例作为对照组。检测并比较2组研究对象的NLR、CRP和GLU水平,采用受试者工作特征曲线(ROC)分析NLR、CRP和GLU单独与联合检测对急性胰腺炎的诊断价值。结果观察组NLR、CRP和GLU水平均高于对照组(P<0.01);入院第1 d患者NLR、CRP和GLU的水平均高于出院前(P<0.05);NLR、CRP和GLU的ROC曲线下面积(AUC)分别为0.975、0.905、0.987,约登指数分别为0.931、0.687和0.919;3项指标联合的ROC曲线下面积值为0.999,约登指数为0.977。3项指标联合检测的诊断效能均高于任一单项指标检测,差异均有统计学意义(P<0.05)。结论单独检测NLR、CRP和GLU对急性胰腺炎的诊断和预后具有一定临床意义,3者联合检测可以提高诊断效能。

Objective To investigate the combined detection value of neutrophil-lymphocyte ratio(NLR),C-reactive protein(CRP)and blood glucose(GLU)in the diagnosis and prognosis of acute pancreatitis.Methods From June 2018 to May 2019,88 patients with acute pancreatitis admitted to the hospital were selected as study objects and set as the observation group.80 health examinees in the same period were selected as the control group.The levels of NLR,CRP and GLU in the two groups were detected and compared,and the diagnostic value of NLR,CRP and GLU for acute pancreatitis was analyzed by ROC.Results The levels of NLR,CRP and GLU in the observation group were higher than those in the control group,with the differences statistically significant(P<0.01).The levels of NLR,CRP and GLU on the first day in hospital were all higher than those before discharge,with the differences statistically significant(P<0.05).Areas under ROC curve(AUC)of NLR,CRP and GLU in the diagnosis of acute pancreatitis were 0.975,0.905 and 0.987,respectively.Youden index were 0.931,0.687 and 0.919,respectively.AUC of the three combined tests was 0.999.Youden index was 0.977.The diagnostic efficacy of the combined detection of the three indicators was all higher than that of any single indicator,and the difference was statistically significant(P<0.05).Conclusion Single detection of NLR,CRP and GLU has certain diagnostic significance and prognosis for acute pancreatitis and combined detection of the three can improve the diagnostic efficiency.