急性胰腺炎后期发生感染性胰腺坏死的相关因素分析  

Related factors for infectious pancreatic necrosis in late stage of acute pancreatitis

作　　者：刘秋霞[1] 杨莹[1] 杨淑晴 谢小培[3] 范展[2] 

机构地区：[1]南阳市中心医院急诊科,河南南阳473000 [2]南阳市中心医院综合治疗室,河南南阳473000 [3]南阳市中心医院肝脏外科,河南南阳473000

出　　处：《中华医院感染学杂志》2017年第1期136-139,共4页Chinese Journal of Nosocomiology

基　　金：河南省科技厅科技发展计划(14A330211)

摘　　要：目的探讨急性胰腺炎后期发生感染性胰腺坏死的影响因素,为临床防治措施的制定提供理论依据。方法回顾性分析2013年1月-2016年7月医院收治的138例急性胰腺炎患者的临床资料,将发生感染性胰腺坏死的69例患者分为A组,将未发生感染性胰腺坏死的69例患者分为B组,对比两组患者的各项临床资料,并将其中有统计学意义的因素通过ROC曲线分析评价其对急性胰腺炎后期发生感染性胰腺坏死的预测价值。结果 A组入院APACHEⅡ评分(15.93±3.48)分,C-反应蛋白(280.08±59.13)mg/L,降钙素原(4.47±1.32)μg/L,均显著高于B组(P<0.05);ROC曲线分析结果显示,入院APACHEⅡ评分的敏感度为88.3%,特异度为69.1%;C-反应蛋白的敏感度为82.1%,特异度为78.2%;降钙素原的敏感度为80.5%,特异度为71.5%(P均<0.05)。结论 APACHEⅡ评分、C-反应蛋白和降钙素原与急性胰腺炎后期发生感染性胰腺坏死密切相关,重视上述指标的评估有助于早期诊断感染性胰腺坏死。OBJECTIVE To explore the influencing factors for infectious pancreatic necrosis in late stage of acute pancreatitis so as to provide theoretical basis for clinical prevention and treatment. METHODS The clinical data of 138 patients with acute pancreatitis who were treated in the hospital from Jan Z013 to Jut 2016 were retrospectively analyzed, 69 patients who had infectious pancreatic necrosis were assigned as the group A, and 69 patients who did not have infectious pancreatic necrosis were assigned as the group B. The clinical data were compared between the two groups of patients. The value of the factors with statistical significance in prediction of infectious pancreatic necrosis in late stage of acute pancreatitis was evaluated by means of ROC cure analysis. RESULTS The APACHE II score of the group A was （15. 93 ± 3. 48） points at the admission to hospital, the C-reactive protein level （280.08 ± 59.13） mg/L, the procaleitonin level （4.47 ± 1.32） μg/L, significantly higher than those of the group B （P〈0.05）. The result of the ROC curve analysis indicated that the sensitivity of the APACHE Ⅱ score was 88.30/6 at the admission to hospital, the specificity 69.1% ; the sensitivity of the C-reactive protein was 82.1%, the specificity 78.2%; the sensitivity of the procalcitonin was 80. 5%, the specificity 71. 5% （all P〈0.05）. CONCLUSION The incidence of infectious pancreatic necrosis in late stage of acute pancreatitis is closely associated with the APACHE Ⅱ score, C-reactive protein, and procalcitonin. It is necessary to focus on the evaluation of the above indicators so as to facilitate the early diagnosis of the infectious pancreatic necrosis.

关 键 词：急性胰腺炎 感染性胰腺坏死 影响因素 

分 类 号：R576[医药卫生—消化系统]