白细胞和乳酸脱氢酶对急性胰腺炎MCTSI评分和预后关系的研究

Study on the relationship between MCTSI score and prognosis of acute pancreatitis by WBC and LDH

目的:研究白细胞(WBC)和乳酸脱氢酶(LDH)对急性胰腺炎改良的CT严重指数(MCTSI)评分和预后的关系。方法:回顾性分析2015年1月1日—2020年12月31日在哈尔滨医科大学附属第四医院就诊的413例急性胰腺炎患者,依照2004年制定的MCTSI评分标准,将患者分为轻症组(n=335例)和非轻症组(n=78例)。采用Spearman分析LDH、WBC与MCTSI评分的相关性;比较2组间患者入院当天的WBC和LDH水平;制作受试者工作特征(ROC)曲线分析WBC和LDH及两指标联合预测MCTSI评分非轻症组的能力;对WBC、LDH、MCTSI评分与住院时间进行相关性分析。结果:(1)LDH、WBC与MCTSI评分间呈正相关。(2)非轻症组患者入院当天WBC和LDH水平显著高于轻症组,差异有统计学意义(P<0.05)。(3)ROC曲线示LDH、WBC以及两者联合预测MCTSI评分非轻症组的AUC值分别为0.705、0.625、0.704,组间比较差异无统计学意义(P>0.05)。(4)WBC、MCTSI评分与住院时间呈正相关。结论:WBC、LDH、MCTSI评分在一定程度上均可以评估患者病情及预后。WBC、LDH及两者联合均可以良好的预测MCTSI评分非轻症胰腺炎的发生。WBC、MCTSI评分可以作为评估患者住院时长的指标。

Objective:To investigate the relationship between white blood cell(WBC)and lactate dehydrogenase(LDH)modified CT severity index(MCTSI)score and prognosis in acute pancreatitis.Methods:A total of 413 patients with acute pancreatitis who visited the Fourth Affiliated Hospital of Harbin Medical University from January 1,2015 to December 31,2020 were retrospectively analyzed and divided into mild group(n=335)and non-mild group(n=78)according to the MCTSI scoring criteria established in 2004.Spearman analysis was used to analyze the correlation between LDH,WBC and MCTSI score.LDH and WBC levels on the day of admission were compared between the two groups.Receiver operating characteristic(ROC)curves were made to analyze the ability of WBC and LDH and the combination of the two indicators to predict the non-mild MCTSI score group.Correlation analysis was performed between WBC,LDH,and MCTSI scores and length of hospital stay and scatter plots were plotted.Results:There was a positive correlation between LDH,WBC and MCTSI score.WBC and LDH levels on the day of admission were significantly higher in the non-mild group than in the mild group,and the difference was statistically significant(P<0.05).ROC curve showed that the AUC values of LDH,WBC and their combination in predicting MCTSI score in the non-mild group were 0.705,0.625,and 0.704,respectively,and there was no significant difference(P>0.05).There was a positive correlation between WBC,MCTSI score and length of hospital stay.Conclusion:WBC,LDH and MCTSI scores can evaluate the condition and prognosis of patients to a certain extent.WBC,LDH and their combination can well predict the occurrence of non-mild MCTSI score.WBC and MCTSI scores can be used as indicators to assess the length of hospital stay.