MCTSI评分及MPV、RDW对急性胰腺炎患者预后不良的预测价值

The predictive value of MCTSI score and MPV and RDW in poor prognosis of patients with acute pancreatitis

目的探讨改良CT严重指数(MCTSI)评分及血小板平均体积(MPV)、红细胞分布宽度(RDW)对急性胰腺炎预后不良的预测价值。方法选取2018年1月至2022年6月在兵器工业五二一医院住院的318例急性胰腺炎患者作为研究对象,根据患者出院后90 d均是否死亡分为预后不良组和预后良好组。比较两组患者的性别、年龄、体质量指数(BMI)、疾病类型、MCTSI评分、MPV、RDW、白细胞计数、红细胞计数、血细胞比容、血红蛋白、总胆固醇(TC)、甘油三酯(TG)、肌酐(Cr)、总胆红素(TBIL)水平。绘制受试者工作特征(ROC)曲线分析MCTSI评分、MPV、RDW对急性胰腺炎患者预后不良的预测价值。采用多因素Logistic回归分析急性胰腺炎患者预后不良的危险因素。结果预后不良组有48例患者,预后良好组有270例患者。预后不良组MCTSI评分高于预后良组,MPV、RDW大于预后良好组,差异均有统计学意义(P<0.05)。ROC曲线分析结果显示,3项指标联合及MCTSI评分、MPV、RDW单独预测急性胰腺炎患者预后不良的曲线下面积分别为0.902、0.852、0.815、0.866。多因素Logistic回归分析结果显示,MCTSI评分≥6.274分、MPV≥11.795 fL、RDW≥15.025%是急性胰腺炎患者预后不良的危险因素(P<0.05)。结论MCTSI评分联合MPV、RDW在急性胰腺炎预后不良中的预测价值较高,在疾病早期对患者的预后进行预测可及时采取有效的治疗措施,改善患者预后。

Objective To investigate the predictive value of modified CT severity index(MCTSI)score,mean platelet volume(MPV)and red blood cell distribution width(RDW)in poor prognosis of patients with acute pancreatitis.Methods A total of 318 patients with acute pancreatitis who were hospitalized in 521 Hospital of Ordnance Industry from January 2018 to June 2022 were selected as the study objects and were divided into poor prognosis group and good prognosis group according to whether the patients died within 90 days after discharge.Gender,age,body mass index(BMI),disease type,MCTSI score,MPV,RDW,white blood cell count,red blood cell count,hematocrit,hemoglobin,total cholesterol(TC),triglyceride(TG),creatinine(Cr)and total bilirubin(TBIL)levels were compared between the two groups.Receiver operating characteristic(ROC)curve was drawn to analyze the predictive value of MCTSI score,MPV and RDW for poor prognosis in patients with acute pancreatitis.Multivariate Logistic regression was used to analyze the risk factors of poor prognosis in patients with acute pancreatitis.Results There were 48 patients in the poor prognosis group and 270 patients in the good prognosis group.The MCTSI score of the poor prognosis group was higher than that of the good prognosis group,and the MPV and RDW were larger than those of the good prognosis group,with statistical significance(P<0.05).ROC curve analysis results showed that the area under the curve of the 3 indexes combined,MCTSI score,MPV and RDW alone predicted the poor prognosis of patients with acute pancreatitis were 0.902,0.852,0.815 and 0.866 respectively.Multivariate Logistic regression analysis showed that MCTSI score≥6.274 points,MPV≥11.795 fL,RDW≥15.025%were risk factors for poor prognosis in patients with acute pancreatitis(P<0.05).Conclusion MCTSI score combined with MPV and RDW has a high predictive value in the prognosis of acute pancreatitis.To predict the prognosis of patients in the early stage of the disease can take effective treatment measures in time to improve the prognosis of patients.