血清AMY、Hcy、D-D水平对急性胰腺炎患者预后的预测价值探究

Prognostic value of serum AMY,Hcy and D-D levels in patients with acute pancreatitis

目的:分析血清淀粉酶(Amylase,AMY)、同型半胱氨酸(Homocysteine,Hcy)、D-二聚体(D-dimer,D-D)水平及联合检测对急性胰腺炎(Acutepancreatitis,AP)患者预后的预测价值。方法:选取2020年5月-2023年6月期间本院收治的AP患者为研究对象。根据患者治疗后的预后情况,将患者分为预后良好组(43例)及预后不良组(19例)。收集并对比两组的一般资料及血清AMY、Hcy、D-D水平。logistic回归模型分析影响AP患者预后的影响因素。分析血清各指标水平联合检测对AP预后的预测效能。结果:预后不良组入院时急性生理功能和慢性健康状况评分系统Ⅱ(Acute physiological function and Chronic health status score SystemⅡscore,APACHEⅡ)评分及血清Hcy、AMY、D-D水平均显著高于预后良好组(P<0.05)。Logistic回归分析显示,入院时血清Hcy、AMY、D-D及APACHEⅡ评分均为患者发生预后不良的危险因素(P<0.05)。入院时AMY、Hcy、D-D水平联合预测患者发生预后不良的曲线下面积(AUC)为0.879。结论:血清AMY、Hcy、D-D水平与AP患者预后密切相关,三者联合检测在患者预后评估中具有重要价值。

Objective:To analyze the prognostic value of serum amylase(AMY),homocysteine(Hcy),D-dimer(D-D)levels and combined detection in patients with acute pancreatitis(AP).Methods:AP patients admitted to our hospital from May 2020 to June 2023 were selected as the research subjects.According to the prognosis of patients after treatment,patients were divided into a good prognosis group(43 cases)and a poor prognosis group(19 cases).General information and serum levels of AMY,Hcy,and D-D were collected and compared between the two groups.A logistic regression model was used to analyze the factors affecting the prognosis of AP patients.The predictive efficacy of combined detection of serum levels of various indicators on the prognosis of AP was analyzed.Results:The scores of Acute physiological function and Chronic health status score SystemⅡscore(APACHEⅡ)and the levels of serum Hcy,AMY,and D-D in the poor prognosis group were significantly higher than those in the good prognosis group at admission(P<0.05).Logistic regression analysis showed that serum Hcy,AMY,D-D,and APACHEⅡscores at admission were all risk factors for poor prognosis in patients(P<0.05).The area under the curve(AUC)of the combined prediction of AMY,Hcy,and D-D levels at admission for poor prognosis was 0.879.Conclusion:The levels of serum AMY,Hcy,and D-D are closely related to the prognosis of AP patients,and the combined detection of the three has important value in the evaluation of patient prognosis.