血液指标在不同程度和类型急性胰腺炎中的表现

The manifestation of blood indexes in different degrees and types of acute pancreatitis

目的探讨血炎症因子和胰腺相关因子在不同严重程度和不同类型急性胰腺炎中的表达特点,并分析相关因子的诊断价值。方法选取我院收治的103例急性胰腺炎患者作为研究对象,根据严重程度和病理类型,对轻度(62例)和重度(41例)患者、胆源性(23例)和非胆源性(80例)患者的血液参数及临床相关资料进行比较,绘制ROC曲线分析在疾病类型中的诊断价值。结果重度组患者白细胞计数、C反应蛋白以及中性粒细胞淋巴细胞比率水平均明显高于轻度组(P<0.05),经ROC分析,C反应蛋白、白细胞计数以及中性粒细胞/淋巴细胞比率对于鉴别重症AP和轻症AP均显著的临床价值,其中以中性粒细胞/淋巴细胞比率敏感性和特异性最佳(AUC=0.937),灵敏度和特异度分别为92.89%、87.78%。胆源性AP患者淀粉酶、脂肪酶水平均高于非胆源性AP,但并不具有鉴别诊断价值。结论在急性胰腺炎发病早期通过快速检测血液炎症因子可较为准确的预测疾病的严重程度,有助于早期治疗方案的制定。

Objective To investigate the expression characteristics of blood inflammatory factors and pancreatic related factors in different severity and types of acute pancreatitis(AP),and to analyze the diagnostic value of related factors.Methods 103 cases of AP patients treated in our hospital from March 2018 to May 2019 were selected as the research objects.Grouped according to the severity and the pathological type,and compared the blood parameters and clinically relevant data of mild AP(62 cases)and severe AP patients(41 cases),gallstone-pancreatitis(23 cases)and non-gallstone-pancreatitis patients(80 cases),then draw the Receiver operating characteristic curve(ROC)to analyze the diagnostic value in disease types.Results The white blood cell count,C-reactive protein and neutrophils ratio of lymphocyte levels in severe AP group were significantly higher than that in mild AP group(P<0.05),the ROC analysis showed that C-reactive protein,white blood cell count and neutrophil/lymphocyte ratio had significant clinical value to identify severe AP and mild AP.The neutrophils/lymphocyte ratio was best(area under the curve,AUC=0.937),which sensitivity and specificity sensitivity were 92.89%,87.78%,respectively.The levels of amylase and lipase in patients with biliary AP were higher than those with non-biliary AP,but they were not of differential diagnostic value.Conclusion The rapid detection of blood inflammatory factors in the early stage of AP could accurately predict the severity of the disease,which was helpful for the formulation of early treatment.