血清抗凝血酶-Ⅲ联合改良CT严重指数评估急性胰腺炎患者病情严重程度及预后的临床价值

Value of serum antithrombin-ⅲcombined with modified CT Severity Index in evaluating the severity and prognosis of acute pancreatitis patients

目的研究血清抗凝血酶-Ⅲ(AT-Ⅲ)联合改良CT严重指数(MCTSI)对急性胰腺炎(AP)患者病情严重程度及预后评估的临床价值。方法以回顾性分析为法,观察对象为2017年1月至2023年1月入皖南医学院第二附属医院的62例AP患者,参考病情严重程度分为轻度组(n=19)、中度组(n=23)和重度组(n=20);同时参考预后情况分为存活组(n=55)与死亡组(n=7)。比较不同组别患者的血清AT-Ⅲ水平与MCTSI评分,并采用受试者工作特征(ROC)曲线评估血清AT-Ⅲ联合MCTSI诊断重度AP及预测AP患者死亡的临床价值。结果重度组患者血清AT-Ⅲ水平为(131.54±36.19)mg/L,明显低于轻、中度组[(255.91±61.36)、(186.75±43.28)mg/L],MCTSI评分为(7.18±1.52)分,明显高于轻、中度组[(3.71±0.68)、(5.11±1.09)分],差异均有统计学意义(P<0.05);中度组患者血清AT-Ⅲ水平明显低于轻度组,MCTSI评分明显高于轻度组,差异均有统计学意义(P<0.05)。死亡组患者血清AT-Ⅲ水平为(100.96±32.43)mg/L,明显低于存活组[(194.05±72.97)mg/L],MCTSI评分为(8.02±1.24)分,明显高于存活组[(4.81±1.52)分],差异均有统计学意义(P<0.05)。ROC曲线分析显示,重度AP诊断中血清AT-Ⅲ水平联合MCTSI评分的敏感度、特异度、曲线下面积(AUC)明显优于单一指标检测,差异均有统计学意义(P<0.05)。ROC曲线分析显示,血清AT-Ⅲ水平联合MCTSI评分预测AP患者死亡的敏感度、特异度、AUC明显优于单一指标检测,差异均有统计学意义(P<0.05)。结论血清AT-Ⅲ联合MCTSI在AP患者病情严重程度及预后评估中具有较高的临床价值。

Objective To study the clinical value of serum antithrombin-Ⅲ(AT-Ⅲ)combined with improved CT severity index(MCTSI)in evaluating the severity and prognosis of acute pancreatitis(AP).Methods By retrospective analysis,62 patients with AP admitted to the Second Affiliated Hospital of Southern Anhui Medical College from January 2017 to January 2023 were observed.According to the severity of their illness,they were divided into mild group(n=19),moderate group(n=23)and severe group(n=20).At the same time,according to the prognosis,they were divided into survival group(n=55)and death group(n=7).The levels of serum AT-Ⅲ and MCTSI scores in different groups of patients were compared,and the clinical value of serum AT-Ⅲ combined with MCTSI in diagnosing severe AP and predicting death in AP patients was evaluated using the receiver operating characteristic(ROC)curve.Results The serum AT-Ⅲ level in severe group was(131.54±36.19)mg/L,which was significantly lower than those in mild group and moderate group[(255.91±61.36),(186.75±43.28)mg/L],and the MCTSI score was(7.18±1.52)points,which was significantly higher than those in mild group and moderate group[(3.71±0.68),(5.11±1.09)points],the differences were statistically significant(P<0.05).The serum AT-Ⅲ level in moderate group was significantly lower than that in mild group,and the MCTSI score was significantly higher than that in mild group,the differences were statistically significant(P<0.05).The serum AT-Ⅲ level in the death group was(100.96±32.43)mg/L,which was lower significantly than that in the survival group[(194.05±72.97)mg/L],and the MCTSI score was(8.02±1.24)points,which was significantly higher than that in the survival group[(4.81±1.52)points],the differences were statistically significant(P<0.05).ROC curve analysis showed that the sensitivity,specificity and AUC of serum AT-Ⅲ level combined with MCTSI score in the diagnosis of severe AP were significantly better than those of single index,with statistical significance(P<0.05).ROC curve analysis showed that the sensitivity,specificity and AUC of serum AT-Ⅲ level combined with MCTSI score in predicting the death of AP patients were significantly better than those of single index,with statistical significance(P<0.05).Conclusion Serum AT-Ⅲ combined with MCTSI has high clinical value in evaluating the severity and prognosis of AP patients.