肌酐、腹部CT与住院天数联合在预测急性重症胰腺炎中的应用效果

Efficacy of combined creatinine,abdominal CT and length of stay in predicting acute severe pancreatitis

目的:在一般信息、实验室检查与影像学检查中筛选急性重症胰腺炎的预测因子并探讨评估价值。方法:回顾性分析鄂尔多斯市中心医院2014年1月至2018年12月期间确诊为急性胰腺炎的患者571例,以病情是否进展为急性重症胰腺炎分为SAP组与NSAP组,一般信息、实验室检查与影像学检查中筛选敏感指标比较两组间差异性,评估SAP预测价值。结果:两组间性别、住院天数、CT有无坏死灶、谷草转氨酶、尿素氮、肌酐、钠离子、淀粉酶、中性粒细胞比率、淋巴细胞比率、嗜酸性粒细胞比率、红细胞分布宽度、血小板差异有统计学意义(P<0.05),进行logistic多因素分析,CT有无坏死灶、住院天数和肌酐是预测患者SAP发生的独立因素;ROC曲线提示联合预测SAP发生率价值较高。结论:CT可见坏死灶、肌酐≥87.25 Umol/L、住院天数≥19.5 d是预测患者SAP发生的独立因素,其联合预测对评估患者病情进展有良好的应用价值。

Objective:To screen the predictors of acute severe pancreatitis in general information,laboratory examinations and imaging examinations and explore the evaluation value.Methods:A retrospective analysis of 571 patients diagnosed with acute pancreatitis in Ordos Central Hospital in January 2014 and December 2018 were divided into SAP group and NSAP group according to whether the disease progressed to acute severe pancreatitis,general information,laboratory examination Compare the differences between the two groups with the screening sensitive indicators in the imaging examination to assess the predictive value of SAP.Results:Gender,length of hospital stay,CT with or without necrosis,aspartate aminotransferase,urea nitrogen,creatinine,sodium ion,amylase,neutrophil ratio,lymphocyte ratio,eosinophil ratio,red blood cell distribution width,The difference in platelets was statistically significant(P<0.05).The logistic multivariate analysis showed that the presence or absence of necrosis on CT,the length of hospital stay,and creatinine were independent factors predicting the occurrence of SAP;the ROC curve suggested that the combination of predicting the incidence of SAP is more valuable.Conclusion:CT visible necrosis,creatinine≥87.25 Umol/L,and hospitalization days≥19.5 days are independent factors predicting the occurrence of SAP,and their combined prediction has a good application value in assessing the progress of patients.