外周血白细胞参数对急性胰腺炎早期严重程度及临床转归的预测价值

Values of peripheral blood leukocyte parameters in prediction of severity of early acute pancreatitis and clinical outcomes

目的 探究白细胞参数水平对急性胰腺炎(AP)早期严重程度及临床转归的预测价值。方法 选取2022年1月—2022年12月甘肃省人民医院急诊科收治住院的AP患者152例为研究对象,根据患者病情严重程度分为轻症胰腺炎(MAP)组75例、复杂性急性胰腺炎(CAP)组77例;根据患者28 d内生存情况分为生存组137例和死亡组15例。另纳入80名健康体检者(设为对照组)作对照;采用受试者工作特征(ROC)曲线探究白细胞参数对AP患者早期严重程度及临床转归的预测价值。结果 与对照组相比MAP组与CAP组除中性粒细胞细胞大小(NE-FSC)、单核细胞细胞大小(MO-Z)参数外,均具有统计学意义(P<0.05)。白细胞计数(WBC)、幼稚粒细胞百分比(IG)、中性粒细胞前向散射光强度分布宽度(NE-WX)、中性粒细胞侧向散射光强度分布宽度(NEWY)对AP严重程度诊断效能较优,将NE-WX、NE-WY进行联合诊断,其敏感性、阴性预测值均高于单一检测。相关性分析显示,WBC、中性粒细胞与淋巴细胞的比值(NLR)、NE-WX、NE-WY、淋巴细胞前向散射光强度分布宽度(LY-WX)水平与AP严重程度呈正相关(P<0.05)。白细胞参数预测CAP患者死亡的ROC曲线结果显示NE-WX、IG灵敏度、特异度较传统指标WBC、NLR有更高的预测价值。结论 白细胞参数NE-WX、NE-WY、IG最终可能被纳入AP严重程度及临床转归的预测系统标志物中。

OBJECTIVE To explore the values of leukocyte parameters in prediction of severity of early acute pan-creatitis(AP)and clinical outcomes.METHODS A total of 152 AP patients who were hospitalized for treatment in emergency department of Gansu Provincial Hospital from Jan 2022 to Dec 2022 were recruited as the research sub-jects and were divided into the mild acute pancreatitis(MAP)group with 75 cases and the complex acute pancrea-titis(CAP)group with 77 cases according to the illness condition of the enrolled patients.The enrolled patients were also divided into the survival group with 137 cases and the death group with 15 cases according to the 28-day survival status.Meanwhile,80 healthy people who received physical examination were chosen as the control group.The values of the leukocyte parameters in prediction of the severity of early AP and clinical outcomes were as-sessed by means of receiver operating characteristic(ROC)curves.RESULTS There were significant differences in all of the parameters except for mean forward scattered light distribution width of the neutrophil(NE-FSC)and mean forward scattered light intensity of the monocyte(MO-Z)between the control group and the MAP group and the CAP group(P<0.05).The white blood cell(WBC)counts,immature granulocyte absolute concentration(IG),side scattered light distribution width of the neutrophil(NE-WX)and fluorescent light distribution width of the neutrophil(NE-WY)had higher efficiencies in diagnosis of severity of AP;the sensitivity and negative predic-tive value of the joint detection of NE-WX and NE-WY were higher than those of the single detection.Correlation analysis showed that WBC,neutrophil to lymphocyte ratio(NLR),NE-WX,NE-WY and side scattered light in-tensity of the lymphocyte(LY-WX)were positively correlated with the severity of AP.ROC curve analysis indica-ted that the sensitivity and specificity of NE-WX and IG were higher than those of the traditional indexes WBC and NLR in prediction of death of the CAP patients.CONCLUSION The leukocyte parameters NE-WX,NE-WY and IG will be ultimately brought into the systematic markers for prediction of the severity of AP and clinical treat-ment outcomes.