血清C-反应蛋白／白蛋白比值对急性胰腺炎患者预后的预测作用  

The role of C -reactive protein/albumin ratio in predicting the prognosis of patients with acute pancreatitis

作　　者：高之峰 王义秋[1] 邢飞[1] 王庄梅 陈光侠[1] GAO Zhifeng;WANG Yiqiu;XING fei;WANG Zhuangmei;CHEN Guangxia(Department of Gastroenterology,the Tirst People＇s Hospital of Xuzhou,Xuzhou,Jiangsu 221002,China)

机构地区：[1]徐州市第一人民医院消化科,江苏徐州221002

出　　处：《徐州医科大学学报》2018年第9期571-574,共4页Journal of Xuzhou Medical University

基　　金：国家自然科学基金青年基金（81602101）;江苏省社会发展重点研发计划（SBE2017740639）

摘　　要：目的探讨血清C-反应蛋白／白蛋白比值（CAR）对急性胰腺炎患者预后的预测作用。方法回顾性分析258例徐州市第一人民医院就诊的急性胰腺炎患者，同时选择年龄、性别等配对的258例正常健康体检者作为对照。提取就诊时研究对象的性别、年龄、白细胞计数、中性粒细胞计数、淋巴细胞计数、降钙素原、C-反应蛋白、血清白蛋白值，计算中性粒细胞／淋巴细胞比值（NLR）、CAR。统计分析NLR、降钙素原、C-反应蛋白、CAR与急性胰腺炎患者病情严重程度及预后的关系。结果与健康对照组相比，急性胰腺炎患者的白细胞计数、NLR、降钙素原、C-反应蛋白以及CAR明显升高（P〈0．05），但淋巴细胞计数明显降低（P〈0．05）。急性胰腺炎病情越严重、合并全身炎症反应综合征、院内死亡的患者，NLR、降钙素原、C-反应蛋白、CAR也越高（P〈0．05）。CAR在预测急性胰腺炎患者预后的特异性、敏感性、约登指数更高。结论血清CAR可预测急性胰腺炎患者预后，其检测特异性、敏感性较目前常用的NLR、降钙素原及C-反应蛋白更高。Objective To explore the role of serum C - reactive protein （CRP）/albumin ratio in predicting the prognosis of patients with acute pancreatitis. Methods A total of 258 cases with acute pancreatitis in our hospital were retrospectively analyzed . At the same time, 258 normal subjects receiving health screening with matched age and sex were selected as healthy controls The data of gender, age, white blood cell count, neutrophil count, lymphocyte count, procalcitonin, CRP, and serum albumin were collected in both groups. The neutrophils/lymphocyte ratio and CRP/albu- rain ratio were calculated. Statistical analysis was used to investigate the relationship of neutrophils/lymphoeyte ratio, procalcitonin, CRP, and serum CRP/albumin ratio with disease severity and prognosis of patients with acute pancreatitis. Results Compared with healthy controls, white blood cell count, neutrophil count, neutrophil/lymphocyte ratio, procal- citonin, CRP and serum CRP/albumin ratio in patients with acute pancreatifis were significantly higher （ P 〈 0.05 ） , However, lymphocyte count was significantly lower in patients with acute pancreatitis compared with healthy controls （P 〈 0.05 ）. The more severe the condition of acute pancreatitis was, combined with systemic inflammatory response syn- drome （SIRS） or hospital death, the higher the neutrophil/lymphocyte ratio, procalcitonin, CRP and serum CRP/albu- rain ratio would be （ P 〈 0.05 ） , The specificity, sensitivity, and Youden index of serum CRP/albumin ratio were higher in predicting the prognosis of patients with acute pancreatitis. Conclusions The serum CRP/albumin ratio could predict the prognosis of patients with acute pancreatitis. The specificity and sensitivity were higher than neutrophils/lymphocyte ratio, procalcitonin and CRP, which are currently commonly used.

关 键 词：急性胰腺炎 血清C-反应蛋白/白蛋白比值 中性粒细肜淋巴细胞比值 降钙素原 C-反应蛋白 

分 类 号：R576[医药卫生—消化系统]