TyG指数、GLR联合BISAP评分对高甘油三酯血症性急性胰腺炎严重程度的早期预测价值分析

Analysis of the early predictive value of TyG index,GLR combined with BISAP score on the severity of hypertriglyceridemic acute pancreatitis

目的分析甘油三酯-葡萄糖(TyG)指数、葡萄糖与淋巴细胞比值(GLR)联合急性胰腺炎严重程度床边指数(BISAP)评分对高甘油三酯血症性急性胰腺炎(HTG-AP)严重程度的早期预测价值。方法回顾性分析2018年5月至2023年5月武汉市第三医院收治的166例HTG-AP患者的临床资料,其中非重症组113例,重症组53例。比较两组入院24 h内采集的临床资料,采用多因素logistic回归分析重症HTG-AP发生的独立影响因素,采用受试者工作特征(ROC)曲线分析TyG指数、GLR、BISAP评分预测重症HTG-AP的效能。结果重症组高血压病、糖尿病人数比例大于非重症组,住院时间长于非重症组,淋巴细胞(LYM)、钙(Ca^(2+))水平低于非重症组,红细胞体积分布宽度(RDW)、D-二聚体(DDI)、C反应蛋白(CRP)、空腹血糖(FPG)、总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、TyG指数、GLR水平及BISAP评分高于非重症组,差异均有统计学意义(P<0.05)。多因素logistic回归分析结果显示,较高水平的TyG指数、GLR、BISAP评分均是促进重症HTG-AP发生的独立危险因素(P<0.05)。ROC曲线分析结果显示,TyG指数、GLR、BISAP评分均具有预测重症HTG-AP发生的应用价值(P<0.05),且BISAP评分联合TyG指数或GLR的预测效能较单一指标更优。结论TyG指数、GLR及BISAP评分与HTG-AP严重程度相关,TyG指数或GLR联合BISAP评分对HTG-AP严重程度有较高的早期预测价值。

Objective To analyze the early predictive value of triglyceride-glucose(TyG)index,glucose-to-lymphocyte ratio(GLR)combined with bedside index for severity in acute pancreatitis(BISAP)score on the severity of hypertriglyceridemic acute pancreatitis(HTG-AP).Methods The clinical data of 166 patients with HTG-AP who were admitted to the Wuhan Third Hospital from May 2018 to May 2023 were retrospectively analyzed,including 113 cases in the non-severe group and 53 cases in the severe group.The clinical data collected within 24 hours of admission were compared between the two groups.Multivariate logistic regression was used to analyze the independent influencing factors of severe HTG-AP.Receiver operating characteristic(ROC)curve was used to analyze the efficacy of TyG index,GLR and BISAP score in predicting severe HTG-AP.Results The proportion of the patients with hypertension and diabetes in the severe group was higher than that in the non-severe group,and the hospital stay in the severe group was longer than that in the non-severe group,and the levels of lymphocytes(LYM)and calcium(Ca^(2+))in the severe group were lower than those in the non-severe group,and the levels of red blood cell volume distribution width(RDW),D-dimer(DDI),C-reactive protein(CRP),fasting plasma glucose(FPG),total cholesterol(TC),triglyceride(TG),high-density lipoprotein cholesterol(HDL-C),low-density lipoprotein cholesterol(LDL-C),TyG index,GLR level,and the BISAP scores in the severe group were higher than those in the non-severe group,and the differences were statistically significant(P<0.05).The results of multivariate logistic regression analysis showed that higher levels of TyG index,GLR and BISAP score were the independent risk factors for promoting the occurrence of severe HTG-AP(P<0.05).The results of ROC curve analysis showed that TyG index,GLR and BISAP score all had application value in predicting the occurrence of severe HTG-AP(P<0.05),and BISAP score combined with TyG index or GLR had better prediction efficacy than a single index.Conclusion TyG index,GLR and BISAP score were correlated with the severity of HTG-AP.TyG index or GLR combined with BISAP score had higher early prediction value for the severity of HTG-AP.