快速序贯器官衰竭评分联合血清同型半胱氨酸、三酰甘油对急性胰腺炎短期预后的预测价值研究

Predictive Value of Rapid Sequential Organ Failure Score Combined with Serum Homocysteine and Triacylglycerol in the Short-Term Prognosis of Acute Pancreatitis

目的:探讨快速序贯器官衰竭评分(qSOFA)联合血清同型半胱氨酸(Hcy)、三酰甘油(TG)对急性胰腺炎(AP)短期预后的预测价值。方法:选取2019年9月至2021年9月苏州大学附属第一医院消化科收治的210例AP患者为研究对象,根据亚特兰大AP分类指南分为轻症AP(MAP组)125例,中重症AP(MSAP组)45例和重症AP(SAP组)40例。对比三组的qSOFA评分和Hcy、TG水平。根据入院后28d预后结局,将所有患者分为存活组192例、死亡组18例。单因素及多因素Logistic回归分析AP患者预后的影响因素。采用受试者工作特征(ROC)曲线分析qSOFA评分、Hcy和TG对AP患者短期预后的预测价值。结果:SAP组和MSAP组患者的qSOFA评分、Hcy、TG水平均高于MAP组患者,且SAP组高于MSAP组(P<0.05);单因素、多因素Logistic回归最终分析结果显示,qSOFA评分较高、TG、Hcy水平升高是AP患者死亡的危险因素(P<0.05);qSOFA评分联合Hcy、TG预测AP患者短期预后的曲线下面积(AUC)为0.982,明显高于三指标单独检测的0.715、0.780、0.782。结论:qSOFA评分、TG、Hcy水平均是AP患者短期预后的影响因素,并且联合检测qSOFA评分和Hcy、TG水平对AP患者的短期预后具有较高的预测价值。

Objective:To explore the predictive value of rapid sequential organ failure score(qSOFA)combined with serum homocysteine(Hcy)and triacylglycerol(TG)in the short-term prognosis of acute pancreatitis(AP).Methods:The 210 AP patients who were admitted to Department of Gastroenterology,the First Affiliated Hospital of Suzhou University from September 2019 to September 2021were selected as the research objects.According to the Atlanta AP classification guidelines,they were divided into 125 cases of mild AP(MAP group),45 cases of moderate and severe AP(MSAP group)and 40 cases of severe AP(SAP group).The qSOFA score,Hcy and TG levels of the three groups were compared.According to the prognosis 28 days after admission,all patients were divided into 192 cases in the survival group and 18 cases in the death group.Univariate and multivariate logistic regression were used to analyze the prognostic factors of AP patients.The predictive value of qSOFA score,Hcy and TG on the short-term prognosis of AP patients was analyzed by receiver operating characteristic(ROC)curve.Results:The qSOFA score,Hcy and TG levels in SAP group and MSAP group were higher than those in MAP group,and those in SAP group were higher than those in MSAP group(P<0.05).Univariate and multivariate logistic regression analysis showed that higher qSOFA score and higher levels of TG and Hcy were the risk factors of death in AP patients(P<0.05).The area under the curve(AUC)of qsofa score combined with Hcy and TG to predict the short-term prognosis of AP patients was0.982,which was significantly higher than 0.715,0.780 and 0.782 detected by the three indexes alone.Conclusion:qSOFA score,TG and Hcy levels are the influencing factors of short-term prognosis of AP patients,and the combined detection of qsofa score,Hcy and TG levels has high predictive value for the short-term prognosis of AP patients.