乳酸脱氢酶、白细胞和血细胞比容在急性胰腺炎严重程度中的诊断价值

Diagnostic value of lactate dehydrogenase,white blood cell and hematocrit in the severity of acute pancreatitis

目的探讨乳酸脱氢酶(lactate dehydrogenase,LDH)、白细胞(white blood cell,WBC)、血细胞比容(hematocrit,HCT)3个实验室指标单项及联合检测在急性胰腺炎(acute pancreatitis,AP)严重程度中的诊断价值。方法选取2015年1月~2020年12月就诊于哈尔滨医科大学附属第一医院的急性胰腺炎患者215例,根据病情严重程度分为非轻症急性胰腺炎(non-mild acute pancreatitis,NMAP)组101例,轻症急性胰腺炎(mild acute pancreatitis,MAP)组114例。比较各组研究对象血清中LDH、WBC、HCT的水平,各指标采用受试者工作曲线(receiver operator characteristic curve,ROC曲线)分析血清LDH、WBC、HCT各单项及3者联合检测在AP严重程度中的诊断价值。结果NMAP组患者的LDH、WBC水平明显高于MAP组的患者(均P<0.05),两组HCT的水平无明显差异(P>0.05);LDH、WBC预测AP患者严重程度的曲线下面积均大于HCT,且3者联合检测的曲线下面积、灵敏度、特异度均高于单项检测(P<0.05)。结论LDH、WBC水平升高可预测NMAP的发生,3者联合检测对早期判断AP严重程度有更高的诊断价值。

Objective To explore the diagnostic value of single and combined detection of lactate dehydrogenase(LDH),white blood cell(WBC)and hematocrit(HCT)in the severity of acute pancreatitis(AP).Methods Two hundred and fifteen patients with acute pancreatitis in the First Affiliated Hospital of Harbin Medical University from January 2015 to December 2020 were selected and divided into non-mild acute pancreatitis(NMAP)group and mild acute pancreatitis(MAP)group according to the severity of the disease.The levels of serum LDH,WBC and HCT in each group were compared,and the diagnostic value of single and combined detection of serum LDH,WBC and HCT in the severity of AP was analyzed by receiver operator characteristic(ROC)curve.Results The levels of LDH and WBC in NMAP group were significantly higher than those in MAP group(all P<0.05).There was no significant difference in the level of HCT between the two groups(P>0.05);The area under the curve of WBC and LDH predicting the severity of AP was larger than that of HCT,and the area of sensitivity and specificity of combined detection under curve of the three were higher than those of single detection(P<0.05).Conclusion The increased levels of LDH and WBC can predict the occurrence of NMAP,and the combined detection of the three indexes can be of higher diagnostic value in early judging the severity of AP.