高脂血症性胰腺炎患者血浆中Ca^(2+)、C-反应蛋白及纤维蛋白原水平变化及其临床意义

Changes in levels of blood calcium,CRP and Fib in plasma of patients with hyperlipidemic acute pancreatitis and their clinical significance

目的:探究高脂血症性胰腺炎(HLAP)患者血浆中Ca^(2+)、C-反应蛋白(CRP)及纤维蛋白原(Fib)水平变化及其临床意义。方法:以108例HLAP患者为研究对象,根据患者病情严重程度分为轻症组(n=29)、中度重症组(n=45)和重症组(n=34)。比较各组患者治疗前后血浆中Ca^(2+)、CRP、Fib水平变化,使用Spearman相关性分析探究治疗前患者病情严重程度与血浆中Ca^(2+)、CRP、Fib指标的相关性。根据患者的治疗结局分为存活组(n=103)和死亡组(n=5)。比较不同治疗结局患者治疗前血浆中Ca^(2+)、CRP、Fib水平,使用受试者特征(ROC)曲线分析患者治疗前血浆中Ca^(2+)、CRP、Fib水平对患者治疗结局的预测效能。结果:治疗5 d后,三组患者CRP水平均较治疗前下降,中度重症组、重症组患者Ca^(2+)水平均较治疗前上升,中度重症组、重症组患者Fib均较治疗前下降(P<0.05);治疗前、治疗5 d后,三组患者同时间点组间Ca^(2+)、CRP、Fib水平比较,差异均有统计学意义(P<0.05)。治疗前,Spearman相关性分析结果显示,患者病情严重程度与Ca^(2+)水平负相关,与CRP、Fib水平正相关(r=-0.890、0.919、0.890,P<0.05);存活组患者CRP、Fib水平低于死亡组(P<0.05),两亚组患者Ca^(2+)水平比较,差异无统计学意义(P>0.05);ROC曲线显示,治疗前血浆中Ca^(2+)、CRP、Fib均具备预测HLAP患者治疗结局的效能(AUC=0.670、0.802、0.929,P<0.05)。结论:血浆中Ca^(2+)、CRP及Fib水平对于评估HLAP患者病情严重程度及预测患者治疗结局均有一定意义。

Objective:To explore the changes in plasma levels of blood calcium(Ca^(2+)),C-reactive protein(CRP)and fibrinogen(Fib)in patients with hyperlipidemic acute pancreatitis(HLAP)and their clinical significance.Methods:108 patients with HLAP were selected as the research subjects.They were divided into mild group(n=29),moderately severe group(n=45)and severe group(n=34)according to the severity of disease.The changes in levels of Ca^(2+),CRP and Fib in plasma were compared among the subgroups of different severity before and after treatment.Spearman correlation analysis was used to explore the correlation between the severity of disease and blood calcium,CRP and Fib before treatment.According to the treatment outcomes,the patients were classified into survival group(n=103)and death group(n=5).The levels of plasma Ca^(2+),CRP and Fib of the different treatment outcome subgroups were compared before treatment,and receiver operating characteristic(ROC)curve was adopted to analyze the predictive efficiency of plasma Ca^(2+),CRP and Fib before treatment on the treatment outcomes of patients.Results:After 5 d of treatment,the CRP in the three subgroups was lower than that before treatment,and the Ca^(2+)in moderately severe group or severe group was higher than that before treatment,and the Fib of patients in moderately severe group or severe group was lower compared with that before treatment(P<0.05).Before treatment and after 5 d of treatment,there were statistically significant differences in the levels of Ca^(2+),CRP and Fib among the three subgroups at the same time point(P<0.05).Spearman correlation analysis showed that the severity of patients with HLAP before treatment was negatively correlated with Ca^(2+),and positively correlated with CRP and Fib(r=-0.890,0.919,0.890,P<0.05).Before treatment,the levels of CRP and Fib in survival group were lower than those in death group(P<0.05),but there was no statistical difference in the Ca^(2+)between the two subgroups(P>0.05).ROC curve results showed that plasma Ca^(2+),CRP and Fib before treatment all had efficiency on predicting the treatment outcomes of patients with HLAP(AUC=0.670,0.802,0.929,P<0.05).Conclusion:The levels of Ca^(2+),CRP and Fib in plasma have certain significance for assessing the severity of patients with HLAP and predicting the treatment outcomes of patients.