Balthazar CT分级联合红细胞分布宽度与重症急性胰腺炎患者预后的相关性

Correlation between Balthazar CT Grade Combined with Red Blood Cell Distribution Width and Prognosis of Patients with Severe Acute Pancreatitis

目的探究Balthazar CT分级联合红细胞分布宽度(RDW)在重症急性胰腺炎(SAP)患者预后中的临床价值。方法回顾性纳入2016年3月~2021年3月收治的376例SAP患者,根据ICU转归情况分为死亡组60例和存活组316例。收集患者入院时临床资料,采用多因素logistic回归分析SAP患者ICU死亡的危险因素,采用受试者工作特征(ROC)曲线评定Balthazar CT分级、RDW预测SAP死亡的预测价值。结果死亡组年龄>70岁、体质指数〉24 kg/m^(2),肾脏替代治疗、手术治疗比例以及超敏C反应蛋白、降钙素原、RDW、D-二聚体(D-D)、Balthazar CT分级评分均高于存活组,差异均有统计学意义(P<0.05)。多因素logistic-回归分析结果表明,Balthazar CT分级评分、RDW、D-D是SAP患者ICU死亡的独立危险因素(P<0.05)。ROC曲线显示,Balthazar CT分级评分联合RDW预测SAP患者ICU死亡的曲线下面积高于Balthazar CT分级评分联合D-D的结果。结论Balthazar CT分级、RDW升高是SAP患者ICU死亡的独立危险因素,两者联合检测可预测该人群ICU死亡的风险。

Objective To explore the value of Balthazar CT grade combined with red blood cell distribution width(RDW)in predicting the prognosis of patients with severe acute pancreatitis(SAP).Methods A retrospective analysis was conducted in 376 SAP patients diagnosed and treated in hospital from March 2016 to March 2021.According to the outcome in ICU,the patients were divided into a death group(60 cases)and a survival group(316 cases).The clinical data of patients at admission were collected.Multivariate logistic regression was used to analyze the risk factors for death of SAP patients in ICU.Receiver operating characteristic(ROC)curve was used to assess the performance of Balthazar CT grading and RDW in predicting death of SAP patients.Results Compared with the survival group,the death group had the higher proportions of patients with age>70 years old,body mass index>24 kg/m^(2),renal replacement therapy,and surgical treatment;higher levels of hypersensitive C-reactive protein(hs-CRP),procalcitonin(PCT),RDW,and D-dimer(D-D);and higher Balthazar CT grade score;the differences were statistically significant(P<0.05).Multivariate logistic regression analysis showed that Balthazar CT grade score,RDW,D-D level were independent risk factors for ICU death of SAP patients(P<0.05).ROC curve showed that the area under the curve of Balthazar CT grade score combined with RDW to predict ICU death of SAP patients was higher than that of Balthazar CT grade score combined with D-D.Conclusion Balthazar CT grade and RDW are independent risk factors for ICU death of SAP patients,and their combined detection may predict the risk of ICU death.