未成熟粒细胞计数、C反应蛋白、中性粒细胞/淋巴细胞、降钙素原结合MCTSI评分在急性胆源性胰腺炎中的诊断价值

Diagnostic value of immature granulocyte count,C-reactive protein,NLR,PCT combined with MCTSI score in acute biliary pancreatitis

目的分析未成熟粒细胞计数(IG)、C反应蛋白(CRP)、中性粒细胞与淋巴细胞比率(NLR)、降钙素原(PCT)及改良CT严重指数评分(MCTSI)在急性胆源性胰腺炎(ABP)病情及并发症预测中的应用价值。方法纳入2020年3月至2022年10月亳州市第二中医院收治的107例ABP患者,检测其治疗前血清CRP、PCT及血浆IG、NLR水平,并比较不同病情、不同并发症发生情况者检测结果差异及MCTSI评分差异。使用受试者工作特征曲线(ROC)及曲线下面积(AUC)分析上述指标评估患者病情、预测并发症风险的效能。结果107例胆源性ABP患者中,轻中度69例、重度38例;21例发生全身并发症、57例发生局部并发症,并发症发生率为72.90%(78/107)。轻中度组IG、CRP、NLR、PCT及MCTSI评分均低于重度组,差异有统计学意义(P<0.05)。未发生组IG、CRP、NLR、PCT及MCTSI评分均低于发生组,差异有统计学意义(P<0.05)。MCTSI评分及IG+CRP+NLR+PCT(综合评估)患者病情的准确率分别为71.96%、78.50%(P<0.05),综合评估患者病情的灵敏度、特异性略高于MCTSI评分。MCTSI评分及综合评估预测患者并发症发生的准确率分别为79.44%、85.05%(P<0.05),综合评估预测患者并发症的灵敏度、特异性略高于MCTSI评分。结论ABP患者病情进展及并发症的发生均伴随着MCTSI评分,以及IG、CRP、NLR、PCT水平的上升,血液指标变化评估患者病情、预测并发症的效能略高于MCTSI评分。

Objective To analyze the application value of immature granulocyte count(IG),C-reactive protein(CRP),neutrophil-lymphocyte ratio(NLR),procalcitonin(PCT)and modified CT severity index score(MCTSI)in predicting the condition and complications of acute biliary pancreatitis(ABP).Methods A total of 107 patients with ABP admitted to Bozhou Second Hospital of Traditional Chinese Medicine from March 2020 to October 2022 were enrolled,and their serum CRP,PCT,plasma IG and NLR levels were detected before treatment.The differences of detection results and MCTSI scores were compared between patients with different conditions and different complications.Receiver operating characteristic curve(ROC)and area under curve(AUC)were used to analyze the effectiveness of the above indicators in evaluating patients'condition and predicting the risk of complications.Results Among 107 patients with ABP,69 cases were mild to moderate and 38 cases were severe.Systemic complications occurred in 21 cases,and local complications occurred in 57 cases,with a complication rate of 72.90%(78/107).The IG,CRP,NLR,PCT and MCTSI score in the mild and moderate group were lower than those in the severe group,with a statistically significant difference(P<0.05).The IG,CRP,NLR,PCT and MCTSI score in the non-occurrence group were lower than those in the occurrence group,with a statistically significant difference(P<0.05).The accuracy of MCTSI score and IG+CRP+NLR+PCT in evaluating patients'condition were 71.96%and 78.50%respectively(P<0.05),and the sensitivity and specificity of IG+CRP+NLR+PCT in evaluating patients'condition were slightly higher than those of MCTSI score.The accuracy of MCTSI score and IG+CRP+NLR+PCT in predicting the occurrence of complications were 79.44%and 85.05%respectively(P<0.05),and the sensitivity and specificity of IG+CRP+NLR+PCT in predicting the occurrence of complications were slightly higher than those of MCTSI score.Conclusion The progress of patients with ABP and the occurrence of complications are accompanied by the increase of MCTSI score,as well as the increase of IG,CRP,NLR and PCT,and the efficacy of blood index changes in evaluating patients'condition and predicting patients'complications is slightly higher than that of MCTSI score.