降钙素原对胰十二指肠切除术后中风险胰瘘患者的早期预测及临床指导价值

Early Prediction and Clinical Guiding Value of Procalcitonin in Patients with Moderate Risk Pancreatic Fistula after Pancreaticoduodenectomy

目的探讨血清降钙素原(PCT)对胰十二指肠切除术(PD)后中风险胰瘘患者的早期预测及临床指导价值。方法回顾性分析2018年6月至2020年6月于郑州大学第二附属医院接受PD后胰瘘危险度评分(FRS)处于中风险的89例患者的临床资料,分为胰瘘组和无胰瘘组。分析术后两组患者的PCT水平,采用受试者工作特征(ROC)曲线分析PCT预测胰瘘的灵敏度和特异性,计算曲线下面积以确定临界值。结果89例患者中有14例发生术后胰瘘,其中B级瘘12例,C级瘘2例。胰瘘组患者术后第1、3、5天的PCT水平高于无胰瘘组(P<0.05),术后第1天PCT值对胰瘘预测的灵敏度最高,临界值为0.77μg·L^(-1),灵敏度为100%,特异性为80%。结论PCT对PD后中风险胰瘘患者具有预测价值,在临床治疗中有参考价值。

Objective To explore the early prediction and clinical guiding value of serum procalcitonin(PCT)in patients with moderate risk pancreatic fistula after pancreaticoduodenectomy(PD).Methods The clinical data of 89 patients at moderate risk of pancreatic fistula risk score(FRS)after PD in the Second Affiliated Hospital of Zhengzhou University from June 2018 to June 2020 were analyzed retrospectively.They were divided into pancreatic fistula group and no pancreatic fistula group.The PCT levels of the two groups were analyzed by statistical methods.The sensitivity and specificity of PCT in predicting pancreatic fistula were analyzed by receiver operating characteristic curve(ROC),and the area under the curve was calculated to determine the critical value.Results There were 14 of the 89 patients had postoperative pancreatic fistula,including 12 cases of grade B fistula and 2 cases of grade C fistula.The PCT level in the pancreatic fistula group on the 1st,3rd and 5th day after operation was higher than that in the non pancreatic fistula group(P<0.05).The PCT value on the 1st day after operation had the highest sensitivity for predicting pancreatic fistula,the critical value was 0.77μg·L^(-1),the sensitivity was 100%,and the specificity was 80%.Conclusion PCT has predictive value for patients with moderate risk pancreatic fistula after PD and has reference value in clinical treatment.