经内镜逆行胰胆管造影术后急性胰腺炎患者的血浆白蛋白水平的变化与预后的相关性

Changes of Plasma Albumin Levels in Patients with Acute Pancreatitis after Endoscopic Retrograde Cholangiopancreatography Correlation with Prognosis

目的:探讨经内镜逆行胰胆管造影术前后急性胰腺炎患者的血浆白蛋白水平的变化与预后的相关性。方法:2015年8月到2019年1月选择在本院诊治的急性胰腺炎患者68例,根据治疗方法的不同分为经内镜逆行胰胆管造影(encoscopic retrograde cholangio pancreatography,ERCP)组和保守治疗组,同期选择在本院进行体检的非胰腺炎患者34例作为对照组。ERCP组患者都给予经内镜逆行胰胆管造影手术治疗,保守治疗组给予内科保守治疗。记录血浆白蛋白水平变化情况,及预后并进行相关性分析。结果:ERCP组和保守治疗组入院时的白细胞计数、中性粒细胞计数、C-反应蛋白、降钙素原均显著高于对照组,淋巴细胞计数、白蛋白均显著低于对照组(P<0.05),且上述指标ERCP组和保守治疗组变化无统计学意义(P>0.05)。在ERCP组和保守治疗组中,术后1 d血浆白蛋白水平低于术前1 d(P<0.05),但是术后3 d、术后7 d显著高于术前1 d,且ERCP组术后术后3 d、术后7 d血浆白蛋白水平显著高于保守治疗组(P<0.05)。在ERCP组治疗的总有效率显著高于保守治疗组(P<0.05);两组并发症发生率对比无统计学意义(P>0.05)。在ERCP组中,选取白蛋白、降钙素原水平等因素,通过logistic回归分析证实白蛋白、降钙素原为影响患者预后的主要危险因素(P<0.05)。结论:急性胰腺炎患者经内镜逆行胰胆管造影手术前后血浆白蛋白水平有显著波动,白蛋白、降钙素原与患者预后显著相关,可预测患者的预后。

Objective:To investigate the correlation between the changes of plasma albumin levels and prognosis in patients with acute pancreatitis before and after pancreatic surgery.Methods:From August 2015 to January 2019,68 patients with acute pancreatitis who were treated in our hospital from August 2015 to January 2019 were divided into two groups:endoscopic retrograde cholangio pancreatography(ERCP)group and conservative treatment group.In the same period,34 patients with non-pancreatitis who underwent physical examination in our hospital were selected as the control group.Patients in the ERCP group were treated with endoscopic retrograde cholangiopancreatography,and the conservative treatment group received conservative medical treatment.Record changes in plasma albumin levels,prognosis and correlation analysis.Results:The white blood cell count,neutrophil count,C-reactive protein and procalcitonin were significantly higher in the ERCP group and the conservative treatment group than in the control group.The lymphocyte count and albumin were significantly lower than the control group(P<0.05).There was no significant difference in the above indicators between the ERCP group and the conservative treatment group(P>0.05).In the ERCP group and the conservative treatment group,plasma albumin levels were lower than 1 day before operation(P<0.05),but significantly higher than 3 days after surgery and 1 day after surgery,and ERCP group.Plasma albumin levels were significantly higher after 3 days and 7 days after surgery(P<0.05).The total effective rate of treatment in the ERCP group was significantly higher than that in the conservative treatment group(P<0.05).There was no significant difference in the incidence of complications between the two groups(P>0.05).In the ERCP group,factors such as albumin and procalcitonin were selected.Logistic regression analysis confirmed that albumin and procalcitonin were the main risk factors for prognosis(P<0.05).Conclusion:Patients with acute pancreatitis have significant fluctuations in plasma albumin levels before and after endoscopic retrograde cholangiopancreatography.Albumin and procalcitonin are significantly associated with prognosis and predict prognosis.