凝血酶-抗凝血酶复合物与红细胞分布宽度检测在急性胰腺炎严重程度及预后评估中的价值

Role of TAT and RDW in evaluation of the severity and prognosis of acute pancreatitis

目的:分析凝血酶-抗凝血酶复合物(TAT)与红细胞分布宽度(RDW)在急性胰腺炎(AP)严重程度及预后评估中的价值。方法:收集75例AP患者基本资料以及入院第1、3、7天的白细胞计数(WBC)、中性粒细胞计数(NE)、RDW、白细胞介素-6(IL-6)、蛋白C(PC)、蛋白S(PS)、TAT。根据病情严重程度分为轻症组(43例)和重症组(32例)。根据出院情况分为生存组(69例)和死亡组(6例)。利用多因素Logistic回归模型进行危险因素分析。采用ROC曲线分析各指标对患者AP严重程度及预后的评估价值。结果:第7天TAT是AP预后的独立危险因素。当第7天TAT大于21.04 ng/ml时,预测AP患者预后效果较好,ROC曲线下面积为0.816(95%CI:0.692~0.940,P<0.05)。重症组第7天RDW与轻症组比较有统计学差异(P<0.05),生存组与死亡组比较无统计学差异(P>0.05),RDW评估AP严重程度及预后效果并不理想。结论:TAT在AP严重程度及预后评估中具有较大临床价值。

Objective:To analyze the value of thrombin-antithrombin complex(TAT)and red blood cell distribution width(RDW)in the evaluation of the severity and prognosis of acute pancreatitis(AP).Methods:The basic data of 75 patients with AP as well as the white blood cell count(WBC),neutrophil count(NE),RDW,interleukin-6(IL-6),protein C(PC),protein S(PS),and TAT was collected.According to the severity of AP,they were divided into mild group(43 cases)and severe group(32 cases).According to the discharge status,they were divided into survival group(69 cases)and death group(6 cases).Multivariate Logistic regression model was used to analyze the risk factors.The ROC curve was used to analyze the evaluation value of each index on the severity and prognosis of AP patients.Results:TAT on day 7 was an independent risk factor for AP prognosis.The prognosis of AP patients was better predicted when TAT on day 7 was greater than 21.04 ng/ml,and the area under the ROC curve was 0.816(95%CI:0.692-0.940,P<0.05).The difference in RDW on day 7 was statistically significant between the severe group and the mild group,and there was no significant difference between the survival group and death group.RDW was not ideal for assessing the severity and prognosis of AP.Conclusion:TAT has greater clinical value in the assessment of the severity and prognosis of AP.