血清铁蛋白和血小板相关参数与高脂血症性急性胰腺炎患者病情及预后的关系分析

Relationship between serum ferritin and platelet parameters in peripheral blood and the condition and prognosis of patients with hyperlipidemic acute pancreatitis

目的分析高脂血症性急性胰腺炎(hyperlipidemic acute pancreatitis,HLAP)患者血清铁蛋白和血小板相关参数变化与患者病情及预后的关系。方法连续性纳入2015年3月至2020年10月西安交通大学第一附属医院收治的470例胰腺炎患者。将HLAP患者根据HLAP严重程度分为轻度HLAP组和重度HLAP组。在患者入院后第1、3、5、7天测定血小板计数、血小板体积(mean platelet volume,MPV)和血清铁蛋白水平。采用受试者工作特征曲线比较MPV、血小板计数和血清铁蛋白对HLAP严重程度的预测能力。结果470例胰腺炎患者中62例(13.2%)为HLAP,其中轻度HLAP 20例,重度HLAP 42例。与轻度HLAP组相比,重度HLAP组入院后第1、3、5天血小板显著降低(P<0.05),且第1、3、5、7天血清铁蛋白显著升高(P<0.05)。入院后第1天血小板计数(AUC=0.741),入院后第3天血清铁蛋白水平(AUC=0.758)和入院后第5天血清铁蛋白水平(AUC=0.732)对重度HLAP的预测能力较强。结论血清铁蛋白和血小板相关参数与HLAP患者病情及预后密切相关。动态监测血清铁蛋白和MPV有助于正确判断HLAP的病情变化。

Objective To investigate the correlation of serum ferritin and platelet parameters with severity and prognosis of patients with hyperlipidemic acute pancreatitis.Method The data of 470 consecutive patients with acute pancreatitis in The First Affiliated Hospital of Xi’an Jiaotong University from March 2015 to October 2020 were analyzed retrospectively.Platelet count,platelet volume(MPV)and serum ferritin on days 1,3,5 and 7 after admission.Receiver operating characteristic curves were used to compare the sensitivity and specificity of MPV,platelet count and serum ferritin in predicting the severity and mortality of HLAP.Result Among 470 patients with acute pancreatitis,62 patients(14.2%)were HLAP.Compared with mild HLAP group,platelets in severe HLAP group decreased significantly on day 1,3 and 5(P<0.05),and serum ferritin increased significantly on day 1,3,5 and 7(P<0.05).Platelet count on day 1 after admission(AUC=0.741),serum ferritin level on day 3(AUC=0.758)and on day 5(AUC=0.732)after admission were more predictive of severe HLAP.Conclusion Serum ferritin and platelet parameters are closely related to the severity and prognosis of HLAP.Dynamic monitoring of serum ferritin and MVP is helpful to diagnose the changes of HLAP and predict the death of patients.