高甘油三酯血症性急性胰腺炎患者血清肌酐、PLT和HCT水平与病情严重程度和预后的关系

Relationship of serum creatinine,PLT and HCT with the severity and prognosis of hyperlipidemic acute pancreatitis

目的分析高甘油三酯血症性急性胰腺炎(HLAP)患者血清肌酐、血小板压积(PLT)和红细胞压积(HCT)水平与病情严重程度及其预后的关系。方法回顾性选取2019年2月至2021年3月遂宁市中心医院收治的108例HLAP患者作为研究对象,按照病情程度分为轻症组(n=68)、中度重症组(n=24)与重症组(n=16),并根据患者预后情况分为预后良好组(n=72)与预后不良组(n=36)。检测不同病情程度、不同预后的HLAP患者血清肌酐、PLT、HCT水平;分析病情程度与肌酐、PLT、HCT相关性,以及血清肌酐、HCT与PLT间的相关性;并以Logistic回归模型分析影响HLAP患者预后的相关因素。结果重症组血清肌酐、HCT水平分别为(169.28±21.73)μmol/L、0.42±0.06,均高于轻症组[(72.49±10.46)μmol/L、0.31±0.05]与中度重症组[(125.87±19.45)μmol/L、0.38±0.04],中度重症组高于轻症组,差异均有统计学意义(P<0.05);重症组PLT为0.09±0.01,低于轻症组(0.14±0.02)与中度重症组(0.12±0.02),中度重症组低于轻症组,差异均有统计学意义(P<0.05)。HLAP患者病情程度与血清肌酐、HCT呈正相关(P<0.05),与PLT呈负相关(P<0.05);血清肌酐、HCT与PLT呈负相关(P<0.05),血清肌酐与HCT呈正相关(P<0.05)。预后不良组血清肌酐、HCT均分别为(172.63±30.45)μmol/L、0.45±0.06,均高于预后良好组[(61.72±11.06)μmol/L、0.37±0.06],PLT为0.08±0.01,低于预后良好组(0.15±0.02),差异均有统计学意义(P<0.05)。Logistic回归分析发现,血清肌酐、HCT为患者预后危险因素(P<0.05),PLT为预后保护因素(P<0.05)。结论血清肌酐、PLT、HCT与HLAP病情程度密切相关,且均为患者预后独立影响因素,其检测可为HLAP诊治及预后评估提供重要依据。

Objective To analyze the relationship of serum creatinine,plateletcrit(PLT)and hematocrit(HCT)with the severity and prognosis of hyperlipidemic acute pancreatitis(HLAP).Methods Totally 108 HLAP patients admitted to Suining Central Hospital from February 2019 to March 2021 were retrospectively selected as the study subjects.According to the severity of the condition,they were divided into mild illness group(n=68),moderate severe illness group(n=24),and severe illness group(n=16).According to the patient's prognosis,they were divided into good prognosis group(n=72)and poor prognosis group(n=36).Serum creatinine,PLT,and HCT levels were detected in HLAP patients with different degrees of illness and prognosis;the correlation between the severity of the disease and creatinine,PLT,HCT,as well as the correlation between serum creatinine,HCT,and PLT were analyzed;the relevant factors that affect the prognosis of HLAP patients were analyzed by Logistic regression model.Results The serum creatinine and HCT levels in the severe group were(169.28±21.73)μmol/L and 0.42±0.06,respectively,which were higher than those in the mild group[(72.49±10.46)μmol/L,0.31±0.05]and the moderate severe group[(125.87±19.45)μmol/L,0.38±0.04],and the differences were statistically significant(P<0.05).The PLT of the severe group was 0.09±0.01,which was lower than those of the mild group(0.14±0.02)and the moderate severe group(0.12±0.02),the moderate severe group was lower than that of the mild group,and the differences were statistically significant(P<0.05).The severity of HLAP was positively correlated with serum creatinine and HCT(P<0.05),and negatively correlated with PLT(P<0.05).Serum Cr and HCT were negatively correlated with PLT(P<0.05),and serum creatinine was positively correlated with HCT(P<0.05).The serum creatinine and HCT of the poor prognosis group were(172.63±30.45)μmol/L and 0.45±0.06,respectively,which were higher than those of the good prognosis group[(61.72±11.06)μmol/L and 0.37±0.06],and the PLT was 0.08±0.01,which was lower than that of the good prognosis group(0.15±0.02),the differences were statistically significant(P<0.05).Logistic regression analysis found that serum creatinine and HCT were prognostic risk factors(P<0.05),and PLT was a protective factor(P<0.05).Conclusion Serum creatinine,PLT and HCT are closely related to the severity of HLAP,and they are all independent prognostic factors.Detection of these indicators can provide an important basis for the diagnosis and prognosis of HLAP.