血钙、C反应蛋白和血清铁蛋白对急性胰腺炎严重程度的预测价值

The value of blood calcium,C-reactive protein and serum ferritin in predicting the severity of acute pancreatitis

目的:评估血钙、C反应蛋白(CRP)和血清铁蛋白单独和联合预测急性胰腺炎严重程度的价值。方法:回顾性研究2017年1月至2022年4月在广西医科大学第一附属医院住院治疗的423例急性胰腺炎患者,其中轻症急性胰腺炎(MAP)306例,中度重症急性胰腺炎(MSAP)73例,重症急性胰腺炎(SAP)44例。比较MAP组和重症胰腺炎组(MSAP+SAP组)患者入院时血钙、CRP和血清铁蛋白水平。采用受试者工作特征(ROC)曲线评估血钙、CRP和血清铁蛋白单独检测及三者联合检测对急性胰腺炎病情的诊断效能。结果:MSAP+SAP组患者CRP和血清铁蛋白水平明显高于MAP组,血钙水平明显低于MAP组(P<0.05)。血钙、CRP、血清铁蛋白预测重症胰腺炎严重程度的ROC曲线下面积(AUC)分别为0.733、0.713、0.711,均低于三者联合检测的0.974(P<0.001)。结论:血钙、C反应蛋白和血清铁蛋白均可作为预测急性胰腺炎严重程度的指标,三者联合可提高预测能力。

Objective:To evaluate the value of serum calcium,C-reactive protein(CRP)and serum ferritin alone and in combination in predicting the severity of acute pancreatitis.Methods:A retrospective study was conducted on 423 patients with acute pancreatitis treated in The First Affiliated Hospital of Guangxi Medical University from January 2017 to April 2022,including 306 cases of mild acute pancreatitis(MAP),73 cases of moderate severe acute pancreatitis(MSAP)and 44 cases of severe acute pancreatitis(SAP).The levels of serum calcium,CRP and serum ferritin were compared between MAP group and MSAP+SAP group on admission.Receiver operating characteristic(ROC)curve was used to evaluate the diagnostic efficacy of serum calcium,CRP and serum ferritin in the diagnosis of acute pancreatitis.Results:CRP and serum ferritin levels were significantly higher in the MSAP+SAP group than in the MAP group,and calcium levels were significantly lower than in the MAP group(P<0.05).The area under the ROC curve(AUC)for blood calcium,CRP and serum ferritin to predict the severity of severe pancreatitis were 0.733,0.713 and 0.711,respectively,which were lower than 0.974 for the combined test of the three(P<0.001).Conclusion:Blood calcium,C-reactive protein and serum ferritin can all be used as predictors of the severity of acute pancreatitis,and the combination of the three can improve the predictive ability.