外周血异型淋巴细胞联合淋巴细胞/中性粒细胞、CRP在急性胰腺炎中的临床价值

Clinical value of peripheral blood atypical lymphocytes combined with lymphocytes/neutrophils and CRP in acute pancreatitis

目的 观察急性胰腺炎(acute pancreatitis, AP)患者外周血异型淋巴细胞、淋巴细胞/中性粒细胞(L/N)、C-反应蛋白(C-reactive protein, CRP)的变化,为有效早期诊断或预测AP患者病情严重程度提供依据。方法 回顾性选择医院轻、中度AP(MAP组)和重、危重AP(SAP组)及非AP(NAP组)急腹症组患者各41例,检测患者外周血异型淋巴细胞、L/N及CRP值,并对其结果进行分析。结果 AP患者异型淋巴细胞检出率(26.83%)高于NAP组(0),MAP组(9.76%)低于SAP组(43.90%),差异均有统计学意义(χ^(2)=13.40、12.20,均P<0.001)。MAP组的外周血L/N(0.24±0.20)高于SAP组(0.12±0.08),CRP水平低于SAP组,差异均有统计学意义(P<0.001)。AP严重程度与异型淋巴细胞、L/N、CRP均呈中等相关(R=0.369、-0.348、0.369,均P<0.01)。结论 外周血异型淋巴细胞联合L/N、CRP,可辅助诊断AP并评估疾病严重程度,是临床诊断AP及预防SAP发生的有效临床指标。

Objective To observe the changes of peripheral blood atypical lymphocytes, lymphocytes/neutrophils(L/N), and C-reactive protein(CRP) in patients with acute pancreatitis(AP) so as to provide a basis for effective early diagnosis or prediction of the severity of the disease in patients with AP. Methods Forty-one patients with mild and moderate AP(MAP group), 41 patients with severe and critical AP(SAP group), and 41 patients with non-AP(NAP group) acute abdomen were retrospectively selected. The peripheral blood atypical lymphocytes, L/N, and CRP values were detected and analyzed. Results The detection rate of atypical lymphocytes in AP patients(26.83%) was higher than that in the NAP group(0), and that in the MAP group(9.76%) was higher than that in the SAP group(43.90%). The differences were statistically significant(χ^(2)=13.40,12.20, both P<0.001). The peripheral blood L/N(0.24SymbolqB@0.20) in the MAP group was higher than that in the SAP group(0.12SymbolqB@0.08), and the CRP level was lower than that in the SAP group. The differences were statistically significant(P<0.001). The severity of AP was moderately correlated with atypical lymphocytes, L/N, and CRP(R=0.369,-0.348, 0.369, all P<0.01). Conclusions Peripheral blood atypical lymphocytes combined with L/N and CRP can assist in the diagnosis of AP and assess the severity of the disease. It is an effective clinical indicator for clinical diagnosis of AP and prevention of SAP.