SIRI、SII及HCAR联合检测对重症急性胰腺炎患者并发感染性胰腺坏死的评估价值

Evaluation value of SIRI,SII and HCAR combined detection in patients with severe acute pancreatitis complicated with infectious pancreatic necrosis

目的分析血清全身炎症反应指数(SIRI)、系统免疫炎症指数(SII)及超敏C-反应蛋白/白蛋白比值(HCAR)联合检测对重症急性胰腺炎(SAP)患者并发感染性胰腺坏死(IPN)的评估价值。方法选取2020年9月至2023年9月绵阳市安州区人民医院收治的122例SAP并发IPN患者为病例组(n=122),另选同期90例SAP无并发IPN患者为对照组(n=90)。收集两组患者的一般资料,并检测血清SIRI、SII、HCAR表达;采用多因素Logistic回归分析SAP患者并发IPN的影响因素;绘制ROC曲线分析血清SIRI、SII、HCAR表达对SAP患者并发IPN的预测价值。结果病例组血清SIRI、SII、HCAR表达均高于对照组,差异有统计学意义(t=11.763、13.406、11.119,均P<0.05);多因素Logistic回归分析显示,年龄≥60岁(OR=1.980)、禁食时间>7 d(OR=1948)、血清SIRI高表达(OR=1.921)、SII高表达(OR=2.006)及HCAR高表达(OR=2.063)均是SAP患者并发IPN的独立危险因素(P<0.05);ROC曲线分析显示,血清SIRI、SII、HCAR表达及联合检测的曲线下面积(AUC)分别为0.881、0.907、0.870、0.943,联合检测优于单一检测(P<0.05)。结论SAP并发IPN受到多种因素影响,血清SIRI、SII、HCAR表达对SAP并发IPN有一定评估价值。

Objective To analyze the value of combined detection of serum systemic inflamma-tory response index(SIRI),systemic immune inflammatory index(SII)and high sensitivity C-reactive pro-tein/albumin ratio(HCAR)in the evaluation of infected pancreatic necrosis(IPN)in patients with severe acute pancreatitis(SAP).Methods A total of 122 SAP patients with IPN admitted to Anzhou District People's Hospital of Mianyang City from September 2020 to September 2023 were retrospectively selected as the case group(n=122),and 90 SAP patients without IPN during the same period were chosen as the control group(n=90).General data from both groups of patients were collected,and the levels of serum SIRI,SII and HCAR were measureed.Multivariate logistic regression was used to analyze the influencing factors of IPN in SAP patients.An ROC curve was drawn to analyze the predictive value of serum SIRI,SII and HCAR expres-sion in SAP patients with concurrent IPN.Results The levels of SIRI,SII and HCAR in the serum of the case group were higher than those in the control group(t=11.763,13.406,11.119,P<0.05).Multivariate lo-gistic regression analysis showed that age≥60 years(OR=1.980),fasting time>7 days(OR=1948),high ex-pression of SIRI(OR=1.921),high expression of SII(OR=2.006)and high expression of HCAR(OR=2.063)in serum were independent risk factors for IPN in SAP patients(P<0.05).ROC curve analysis demonstrated that the expression of SIRI,SII,and HCAR in serum and the area under the curve(AUC)of combined detec-tion,were 0.881,0.907,0.870 and 0.943,respectively.Combined detection was superior to single detection(P<0.05).Conclusion The expression of SIRI,SII,and HCAR in serum has a certain value in evaluating SAP concurrent IPN,as it is affected by many factors.