血液AMY、FIB及SCr与老年急性胰腺炎患者MCTSI评分和预后关系的研究

Study of the relationship between blood AMY, FIB and SCr and MCTSI score and prognosis of elderly patients with acute pancreatitis

目的研究血液淀粉酶(AMY)、纤维蛋白原(FIB)及血肌酐(SCr)与老年急性胰腺炎患者MCTSI评分和预后关系。方法收集2019年1月—2021年1月北京积水潭医院收治的97例老年急性胰腺炎患者为观察组,同期在北京积水潭医院体检的60岁以上健康者60例为对照组,比较2组血液AMY、FIB及SCr水平,比较预后不良和预后良好患者MCTSI评分及血液AMY、FIB、SCr水平,分析血液AMY、FIB、SCr与患者MCTSI评分和预后的相关性,通过受试者工作特征曲线(ROC),分析各指标对急性胰腺炎预后不良的预测价值。结果与对照组比较,观察组血液AMY、FIB及SCr水平增加(P<0.05);预后不良患者MCTSI评分及血液AMY、FIB、SCr水平均高于预后良好患者(P<0.05);血液AMY、FIB、SCr水平与急性胰腺炎患者MCTSI评分呈正相关(P<0.05),与预后呈负相关(P<0.05);ROC曲线分析显示,AMY、FIB及SCr联合预测急性胰腺炎预后不良的AUC为0.907、特异度为82.35%、灵敏度为87.30%。结论老年急性胰腺炎患者血液中AMY、FIB及SCr明显上调,与患者MCTSI评分和预后情况关联密切,3项指标水平联合检测有助于急性胰腺炎病情及预后评估,具有一定临床价值。

Objective To study the relationship between serum amylase(Amy),fibrinogen(FIB),and serum creatinine(SCr)and MCTSI score and prognosis of elderly patients with acute pancreatitis.Methods 97 elderly patients with acute pancreatitis treated in Beijing Jishuitan Hospital from January 2019 to January 2021 were selected as the observation group and 60 healthy elderly people who received a physical examination at the same hospital during the same period were selected as the control group.The levels of blood Amy,FIB and SCr were compared between the two groups.MCTSI score and levels of blood Amy,FIB and SCr were compared between the patients with poor prognosis and the patients with good prognosis.The correlation between blood Amy,FIB,SCR and MCTSI score and prognosis of the patients was analyzed.According to the receiver operating characteristic curve(ROC),the predictive value of each index for the poor prognosis of acute pancreatitis was analyzed.Results Compared with the control group,the levels of blood Amy,FIB and SCr of the observation group increased significantly(P<0.05).MCTSI score and the levels of blood Amy,FIB and SCr of patients with poor prognosis were significantly higher than those of patients with good prognosis(P<0.05).The levels of blood Amy,FIB and SCr were positively correlated with MCTSI score in patients with acute pancreatitis(P<0.05),and negatively correlated with the prognosis(P<0.05).ROC curve analysis showed that the AUC of combined detection of Amy,FIB and SCr in predicting poor prognosis of acute pancreatitis was 0.907,the specificity was 82.35%,and the sensitivity was 87.30%.Conclusion The levels of blood Amy,FIB and SCr in patients with acute pancreatitis are significantly up-regulated,which is closely related to MCTSI score and prognosis of the patients.The combined detection of the three indexes is helpful to evaluate the condition and prognosis of acute pancreatitis.