D二聚体检测在重症急性胰腺炎预后评估中的应用价值

Application Value of D-dimer Detection in Prognosis Evaluation of Severe Acute Pancreatitis

目的探讨D二聚体(D-D)检测在重症急性胰腺炎(SAP)预后评估中的价值。方法以82例SAP患者为对象,根据患者在住院期间预后情况分为生存组(n=80)和死亡组(n=12)。检测入ICU时及入ICU 24 h时D-D水平,分析其与患者预后的关系。结果死亡组C反应蛋白(CRP)、腹腔高压(IAH)、24 h APACHE II评分、住ICU时间高于生存组(P<0.05);死亡组胰腺感染、外科手术发生率分别为58.33%、33.33%,高于对照组(11.43%、7.14%,P<0.05)。死亡组入ICU时、入ICU24 h D-D水平高于生存组(P<0.05)。入ICU时D-D预测SAP患者预后的AUC、敏感度、特异度分别为0.962(95%CI:0.895~0.992)、100.00%、87.14%;入ICU24 h时D-D预测SAP患者预后的AUC、敏感度、特异度分别为0.998(95%CI:0.951~1.000)、100.00%、97.14%。结论SAP患者入院后应尽早检测D-D水平,评估患者病情及预后,对早期干预治疗,降低死亡率具有积极意义。

Objective To investigate the value of D-Dimer(D-D)in the prognosis of severe acute pancreatitis(SAP).Methods 82 patients with SAP were divided into survival group(n=80)and death group(n=12).The D-D level was detected when entering the ICU and 24 hours after entering the ICU,and its relationship with the prognosis of patients was analyzed.Results C-reactive protein(CRP),abdominal hypertension(IAH),24 h APACHE II score and ICU stay in the death group were higher than those in the survival group(P<0.05);The incidence of pancreatic infection and surgery in the death group were 58.33%and 33.33%respectively,which were higher than those in the control group 11.43%and 7.14%(P<0.05).The level of D-D in the death group was higher than that in the survival group(P<0.05).The AUC,sensitivity and specificity of D-D in predicting the prognosis of SAP patients were 0.962(95%CI:0.895~0.992),100.00%and 87.14%,respectively;The AUC,sensitivity and specificity of D-D in predicting the prognosis of SAP patients were 0.998(95%CI:0.951~1.000),100.00%and 97.14%,respectively.Conclusion The D-D level of SAP patients should be detected as soon as possible after admission,and the condition and prognosis of SAP patients should be evaluated.It is of positive significance for early intervention and reducing mortality.