外周血PCT、PLR与急性胰腺炎严重程度的相关性及其对预后的预测价值分析

Analysis of the Correlation between Peripheral Blood PCT,PLR and the Severity of Acute Pancreatitis and Their Predictive Value for Prognosis Authors

目的分析外周血降钙素原(PCT)、血小板与淋巴细胞比值(PLR)与急性胰腺炎严重程度的相关性及PCT、PLR对急性胰腺炎预后不良的预测价值。方法选取苏州市相城人民医院2018年1月至2022年6月期间接诊的112例急性胰腺炎患者,于患者入院后24 h检测外周血PCT水平,计算PLR,根据患者严重程度情况将其分为预后良好组和预后不良组。以受试者工作特征曲线(ROC)分析外周血PCT、PLR水平对急性胰腺炎预后不良患者的预测价值。结果112例急性胰腺炎患者中,预后不良组22例(19.64%),预后良好组90例(80.36%)。两组患者的一般资料、血清肌酐(CREA)、血钙、外周血白细胞比较,差异均无统计学意义(P>0.05);预后不良组外周血PCT、PLR水平均显著高于预后良好组,差异有统计学意义(P<0.05)。外周血PCT、PLR表达水平偏高均为急性胰腺炎预后不良患者的相关因素,差异有统计学意义(P<0.05)。ROC分析显示,外周血PCT、PLR水平单一及联合对急性胰腺炎预后不良患者的ROC预测的灵敏度分别为62.54%、70.85%、89.85%,特异度分别为75.89%、74.69%、72.58%,曲线下面积(AUC)分别为0.785、0.796、0.889,且外周血PCT、PLR水平单一对急性胰腺炎预后不良患者的预测效能均低于联合,差异有统计学意义(P<0.05)。结论急性胰腺炎预后不良患者外周血PCT、PLR表达水平较高,外周血PCT、PLR表达水平均对急性胰腺炎预后不良患者具有一定的临床预测效能。

Objective To analyze the correlation between peripheral blood procalcitonin(PCT),platelet to lymphocyte ratio(PLR)and the severity of acute pancreatitis,and the predictive value of PCT and PLR for poor prognosis of acute pancreatitis.Methods A total of 112 patients with acute pancreatitis who were admitted to Xiangcheng People’s Hospital from January 2018 to June 2022 were selected.The levels of peripheral blood PCT were measured and PLR was calculated 24 hours after admission.According to the severity of the patients,they were divided into good prognosis group and poor prognosis group.The predictive value of peripheral blood PCT and PLR levels for patients with poor prognosis of acute pancreatitis was analyzed by receiver operating characteristic(ROC)curve.Results Among the 112 patients with acute pancreatitis,there were 22 cases(19.64%)in the poor prognosis group and 90 cases(80.36%)in the good prognosis group.There was no significant difference in general data,serum creatinine(CREA),blood calcium,and peripheral blood leukocytes between the two groups(P>0.05).The levels of peripheral blood PCT and PLR in the poor prognosis group were significantly higher than those in the good prognosis group,and the difference was statistically significant(P<0.05).High expression levels of peripheral blood PCT and PLR were both related factors for patients with poor prognosis of acute pancreatitis,and the difference was statistically significant(P<0.05).ROC analysis showed that the sensitivity of ROC prediction for patients with poor prognosis of acute pancreatitis by single and combined peripheral blood PCT and PLR levels were 62.54%,70.85%,and 89.85% respectively,and the specificity were 75.89%,74.69%,and 72.58% respectively.The area under the curve(AUC)were 0.785,0.796,and 0.889 respectively.The predictive efficacy of single peripheral blood PCT and PLR levels for patients with poor prognosis of acute pancreatitis was lower than that of the combination,and the difference was statistically significant(P<0.05).Conclusion Patients with poor prognosis of acute pancreatitis have higher expression levels of peripheral blood PCT and PLR.Both peripheral blood PCT and PLR levels have certain clinical predictive efficacy for patients with poor prognosis of acute pancreatitis.