血清淀粉酶及白蛋白联合乳酸脱氢酶检测在急性胰腺炎临床诊断及病情评估中的作用

Analysis of the role of serum amylase,albumin combined with lactate dehydrogenase in the clinical diagnosis and evaluation of acute pancreatitis

目的探讨血清淀粉酶、白蛋白联合乳酸脱氢酶检测在急性胰腺炎临床诊断、病情评估中的作用。方法回顾性分析2018年2月~2021年10月于首都医科大学附属北京世纪坛医院治疗的123例急性胰腺炎患者的临床资料,将其设为观察组,同时选取同时期进行健康体检的87例患者设为健康组。根据病情严重程度将观察组分为轻症组(n=44)和重症组(n=79),比较患者不同病情程度者淀粉酶、白蛋白、乳酸脱氢酶水平,分析影响急性胰腺炎发生的危险因素及血清淀粉酶、白蛋白联合乳酸脱氢酶检测对急性胰腺炎的临床诊断价值。结果观察组患者淀粉酶、乳酸脱氢酶水平均高于健康组,白蛋白水平低于健康组(均P<0.05)。轻症组与重症组淀粉酶水平差异无统计学意义(P>0.05),轻症组患者乳酸脱氢酶水平及白蛋白水平均低于重症组(P<0.05)。经多因素Logistic回归模型分析结果得出,暴饮暴食、酗酒、淀粉酶、白蛋白、乳酸脱氢酶为影响急性胰腺炎发生的独立危险因素(P<0.05)。ROC曲线示:淀粉酶、白蛋白、乳酸脱氢酶单独检测为0.793、0.701、0.725,三者联合检测为0.896,三者联合检测AUC值较单独检测大。结论血清淀粉酶、白蛋白、乳酸脱氢酶三者联合检测可用于急性胰腺炎临床诊断,能为准确评估患者病情提供有效的资料。

Objective To analyze the role of serum amylase,albumin combined with lactate dehydrogenase in the clinical diagnosis and evaluation of acute pancreatitis.Methods The clinical data of 123 patients with acute pancreatitis treated in Beijing Shijitan Hospital Affiliated Capital Medical University Hospital from February 2018 to October 2021 were retrospectively analyzed,and they were set as the study group,at the same time,87 patients who underwent physical examination during the same period were selected as healthy group.The levels of amylase,albumin,and lactate dehydrogenase in the study group and the control group,and in patients with different disease levels were compared,the risk factors that affected the occurrence of acute pancreatitis were analyzed,and the clinical diagnostic value of serum amylase and albumin combined with lactate dehydrogenase for acute pancreatitis was analyzed.Results The levels of amylase and lactate dehydrogenase in the study group were higher than those in the healthy group,and the albumin level was lower than that in the healthy group(P<0.05).There was no statistically significant difference in amylase level between the two groups(P>0.05),the level of lactate dehydrogenase in the mild group was lower than that in the severe group,and the albumin level was lower than that in the severe group(P<0.05).The results of multivariate logistic regression analysis showed that binge eating,alcohol abuse,amylase,albumin,and lactate dehydrogenase were independent risk factors that affected the occurrence of acute pancreatitis(P<0.05).ROC curve showed:the AUC of amylase,albumin,lactate dehydrogenase tested separately and the three combined detection were 0.793,0.701,0.725,0.896,respectively,of which the AUC value of the combined detection of the three was the largest.Conclusion The detection of serum amylase and albumin combined with lactate dehydrogenase can be used in the clinical diagnosis of acute pancreatitis,and provide effective data for accurately assessing the patient's condition.