中度急性胰腺炎红细胞压积的变化意义  

Hematocrit for early assessment of acute pancreatitis

作　　者：郭志国[1] 王龙[1] 辛毅[1] 

机构地区：[1]宿州市立医院消化内科,安徽省宿州市234000

出　　处：《世界华人消化杂志》2014年第22期3325-3329,共5页World Chinese Journal of Digestology

基　　金：宿州市科技计划基金资助项目(自筹);No.[2012]82号-11~~

摘　　要：目的:研究中度急性胰腺炎(moderately severe acute pancreatitis,MSAP)时红细胞压积的变化.方法:选取2012-01/2013-06住院的急性胰腺炎(acute pancreatitis,AP)患者,根据病情分轻、中、重三种.全自动血液细胞分析仪检测红细胞压积,检测入院时及入院后24 h内各组红细胞压积值;检测24 h内红细胞压积变化;将红细胞压积水平对MSAP影响进行接收者操作特徵(receiver operating characteristic,ROC)曲线特征分析.结果:符合要求者94例,65例轻度急性胰腺炎与8例重度急性胰腺炎(severe acute pancreatitis,SAP)相比:入院时及入院后24 h内红细胞压积变化均有显著性差异(P<0.05);65例MSAP与8例SAP相比:入院时红细胞压积变化差异有显著性(P<0.05),入院时红细胞压积≥38%预测MSAP的敏感性、特异性及阳性预测值分别为57%、51%和88%.结论:入院时红细胞压积≥38%患者发生MSAP可能性较大.AIM： To assess the significance of changes in hematocrit in patients with moderately severe acute pancreatitis （MSAP）. METHODS： A cohort study was performed on patients admitted with AP from January 2012 to June 2013. AP was defined according to the At- lanta classification and patients were categorized into three groups - mild AP, moderate AP and severe AP. Hematocrit （HCT） levels were calcu- lated to determine risk of severity associated with elevated HCT level at admission and rise in HCT level at 24 h. Accuracy of the HCT was determined by the area under the receiver operating characteristic curve （ROC） analysis. RESULTS： A total of 94 AP cases were included in analysis, of whom 8 had severe AP, 65 had mild AP, and 21 had moderate AP. HCT levels at admission and at 24 h was significantly dif-ferent between patients with mild AP and those with severe AP （P 〈 0.05）. HCT levels at admis- sion differed significantly between patients with moderate AP and those with severe AP （P 〈 0.05）. The sensitivity of hematocrit ≥38% as a marker for detection of moderate AP at admission was 57%, the specificity was 51% and the positive predictive value was 88%. CONCLUSION： Hematocrit ≥38% is probably used to detect moderate AP at the time of admis- sion.

关 键 词：急性胰腺炎 血液浓缩 红细胞压积 

分 类 号：R576[医药卫生—消化系统]