红细胞分布宽度与血钙比值结合BISAP评分对急性胰腺炎严重程度的预测价值

Value of red cell distribution width to serum calcium ratio combined BISAP scores in assessment of the severity of acute pancreatitis

目的探讨红细胞分布宽度(RDW)与血钙比值(RCR)结合急性胰腺炎严重程度床边指数(BISAP)评分对急性胰腺炎(AP)严重程度的预测价值。方法回顾性分析我院2018年6月~2019年6月诊断为急性胰腺炎的患者132例,按疾病严重程度分为重症急性胰腺炎(SAP)组和轻、中度急性胰腺炎(非SAP)组,收集两组患者的基线资料进行统计分析。结果SAP组患者RDW、RCR、BISAP评分在入院后第1、3、7 d均明显高于非SAP组,SAP组患者Ca^(2+)在入院后第1、3、7 d均明显低于非SAP组(P<0.05)。两组患者RDW、RCR、BISAP评分均随住院时间延长呈下降趋势,Ca^(2+)住院时间延长呈上升趋势(P<0.05)。非SAP组、SAP组的RCR均在第1 d处于最高水平,随后随着住院时间的推移逐渐降低(均P<0.05);ROC曲线结果显示:BISAP评分的曲线下面积(AUC)为0.848,RCR为0.744,高于RDW(ROC:0.695)、Ca^(2+)(ROC:0.650)(P<0.05),而RCR联合BISAP评分的AUC(0.883)最高,灵敏度为79.31%,特异度为91.26%。结论RCR可以作为预测AP严重程度的指标,结合BISAP评分,可较准确的预测AP严重程度。

Objective To explore the value of red cell distribution width to serum calcium ratio combined BISAP scores in assessment of the severity of acute pancreatitis(AP).Methods This retrospective research analyzed 132 patients with AP treated in our department from June,2018 to June,2019.According to the severity,the patients were classified into severe acute pancreatitis(SAP)group and mild or moderately severe acute pancreatitis(non-SAP)group.The demographic data was analyzed.Results The RCR of patients in the SAP group was significantly higher on the 1st,3rd and 7th days after hospitalization than in the non-SAP group,at the same time,non-SAP group,SAP group,RCR is at the highest level on the first day,followed by the gradual decrease in hospital stay,more statistically significant(P<0.05).The results of the ROC curve show that the area under the curve(AUC)of the BISAP score is 0.848,the RCR is 0.744,RDW(ROC:0.695),Ca 2+(ROC:0.650),and the AUC(0.883)of the RCR combined BISAP score is the highest,with sensitivity of 79.31%and specialty of 91.26%.Conclusion RCR can be used as an indicator to predict AP severity,combined with BISAP score,to predict AP severity more accurately.