外周血HBP、SAA和IG%在急性胰腺炎中的诊断价值

Diagnostic value of peripheral blood HBP,SAA and IG% in the diagnosis of acute pancreatitis

目的探讨外周血肝素结合蛋白(HBP)、淀粉样蛋白A(SAA)和未成熟粒细胞百分率(IG%)在急性胰腺炎(AP)中的诊断价值,以期为临床诊疗提供参考依据。方法选取2021年6月至2023年8月该院收治的121例AP患者作为研究对象,根据AP的分级标准将其分为轻症AP组(MAP组,63例)、中重症AP组(MSAP组,36例)和重症AP组(SAP组,22例);另选取同期在该院体检的80例健康体检者作为对照组。检测并比较各组研究对象临床资料及外周血HBP、SAA水平和IG%。采用Spearman相关分析HBP、SAA水平和IG%与AP病情严重程度的相关性;绘制受试者工作特征(ROC)曲线评估外周血HBP、SAA和IG%对AP的诊断价值。结果4组性别、年龄、发病时间比较,差异均无统计学意义(P>0.05)。HBP、SAA水平为SAP组>MSAP组>MAP组>对照组,且任意两组间比较,差异均有统计学意义(P<0.05)。SAP组和MSAP组IG%高于MAP组和对照组,且SAP组IG%高于MSAP组,差异均有统计学意义(P<0.05),但MAP组与对照组IG%比较,差异无统计学意义(P>0.05)。Spearman相关分析结果显示,HBP、SAA水平和IG%与AP病情严重程度均呈正相关(r=0.762、0.823、0.724,P<0.05)。ROC曲线分析结果显示,外周血HBP、SAA、IG%单独及HBP+SAA和HBP+SAA+IG%联合诊断AP的曲线下面积(AUC)分别为0.700(95%CI:0.627~0.773)、0.787(95%CI:0.726~0.848)、0.460(95%CI:0.378~0.542)、0.850(95%CI:0.792~0.907)和0.860(95%CI:0.811~0.908)。结论外周血HBP和SAA联合检测对AP有较高的诊断价值,IG%单独诊断AP的价值不高;外周血HBP、SAA和IG%联合检测有助于临床评估AP病情严重程度,尤其是对预测MSAP和SAP有重要价值。

Objective To explore the diagnostic value of peripheral blood heparin binding protein(HBP),amyloid A(SAA)and immature granulocyte percentage(IG%)levels in the diagnosis of acute pancreatitis(AP),so as to providing a reference basis for clinical diagnosis and treatment.Methods A total of 121 AP patients treated in this hospital from June 2021 to August 2023 were selected as the research objects,who were divided into the mild AP group(MAP group,n=63),the moderate-severe AP group(MSAP group,n=36)and the severe AP group(SAP group,n=22)according to the severity of the disease,meanwhile 80 cases of healthy medical checkups in the same period of time in this hospital were selected as the control group.Clinical data and peripheral blood HBP,SAA levels and IG%of the study subjects in each group were compared.The Spearman correlation analysis was adopted to analyze the correlation of HBP,SAA and IG%levels with the severity of AP.The diagnostic value of peripheral blood HBP,SAA and IG%for early AP was assessed by plotting the receiver operating characteristic(ROC)curve.Results The clinical data of the four groups showed no statistically significant difference(P>0.05).The levels of HBP and SAA in the SAP group>the MSAP group>the MAP group>the control group,and the difference between any two groups was statistically significant(P<0.05).The IG%in the SAP group and the MSAP group were higher than those in the MAP group and the control group,and the IG%level in the SAP group was higher than that in the MSAP group,with statistically significant differences(P<0.05),but the difference in IG%between the MAP group and the control group was not statistically significant(P>0.05).Spearman′s correlation analysis showed that HBP,SAA levels and IG%were all positively correlated with severity of AP(P<0.05).The results of the ROC curve showed that the area under the curve(AUC)for diagnosing AP of peripheral blood HBP,SAA,IG%,HBP+SAA and HBP+SAA+IG%were 0.700(95%CI:0.627-0.773),0.787(95%CI:0.726—0.848),0.460(95%CI:0.378-0.542),0.850(95%CI:0.792—0.907)and 0.860(95%CI:0.811-0.908),respectively.Conclusion The combined detection of peripheral blood HBP and SAA has high diagnostic value for AP,while IG%is of little value;the combined detection of peripheral blood HBP,SAA and IG%is helpful to clinically assess the severity of AP,especially valuable for predicting MSAP and SAP.