RDW、MPV联合炎症指标、PCT及APACHEII评分对急性胰腺炎病情的预测价值  

Predictive value of RDW,MPV combined inflammatory indicators,PCT,APACHEII score in acute pancreatitis

作　　者：李丹[1] 刘凤奎[1] 王国兴[1] LI Dan;LIU Feng-kui;WANG Guo-xing(Department of Emergency,Beijing Friendship Hospital,Capital Medical University,Beijing 100050,China.)

机构地区：[1]首都医科大学附属北京友谊医院急诊科

出　　处：《临床和实验医学杂志》2019年第18期1943-1947,共5页Journal of Clinical and Experimental Medicine

基　　金：国家自然科学基金(编号:81773931)

摘　　要：目的探讨急性胰腺炎(AP)患者红细胞分布宽度(RDW)、平均血小板体积(MPV)与血白细胞(WBC)、C反应蛋白(CRP)及血清降钙素原(PCT)的关系,评估RDW、MPV、WBC、CRP、PCT及急性生理与慢性健康状况(APACHEII)评分对AP严重程度的预测价值。方法回顾性研究收集2014年1月至2017年12月首都医科大学附属北京友谊医院住院的急性胰腺炎患者383例,按疾病严重程度分为轻度(MAP)组161例、中度(MSAP)组140例、重度(SAP)组82例,收集患者的一般资料,检测RDW、MPV、WBC、CRP、PCT,并进行APACHEII评分,比较三组RDW、MPV、WBC、CRP、PCT及APACHEII评分水平,统计RDW、MPV与WBC、CRP、PCT及APACHEII评分之间的相关性,利用ROC曲线评估上述指标对急性胰腺炎病情预测价值。结果与MAP组比较,MSAP组患者RDW、WBC、CRP、PCT、APACHEII评分水平较高,差异具有统计学意义(P <0. 05);与MSAP组比较,SAP组患者RDW、MPV、WBC、CRP、PCT、APACHEII评分水平较高,差异具有统计学意义(P <0. 05);相关性分析结果显示,急性胰腺炎患者RDW与WBC、CRP、PCT、APACHEII评分均呈正相关(P <0. 05),MPV与WBC、PCT正相关(P <0. 05)。WBC、RDW、MPV、CRP、PCT、APACHEII评分都可以有效预测SAP,曲线下面积(AUC)均大于0. 5,联合检测AUC值为0. 995。结论急性胰腺炎患者随着病情加重,RDW、MPV、WBC、CRP、PCT水平升高,RDW、MPV、WBC、CRP、PCT检测及APACHEII评分对评估急性胰腺炎病情及预后具有良好的应用价值。Objective To investigate the relationship between erythrocyte distribution width( RDW),mean platelet volume( MPV),leukocyte( WBC),C-reactive protein( CRP) and serum procalcitonin( PCT) in patients with acute pancreatitis( AP). To evaluate the severity predictive value of RDW,MPV,WBC,CRP,PCT and Acute Physiological and Chronic Health Status( APACHEII) Score for AP. Methods A retrospective study with 383 patients with acute pancreatitis admitted to Beijing Friendship Hospital of Capital Medical University from January2014 to December 2017 was performed. The patients were divided into mild( MAP) group with 161 cases,moderate( MSAP) group with 140 cases and severe( SAP) group with 82 cases,according to the severity of the disease. General information of patients,RDW,MPV,WBC,CRP,PCT,and carry out APACHEII score were recorded. The levels of RDW,MPV,WBC,CRP,PCT and APACHEII score in the three groups were compared,and the correlation between RDW,MPV,WBC,CRP,PCT and APACHEII score were evaluated. Results Compared with MAP group,the levels of RDW,WBC,CRP,PCT and APACHEII score in MSAP group were significantly higher( P < 0. 05). Compared with MSAP group,the levels of RDW,MPV,WBC,CRP,PCT and APACHEII score in SAP group were significantly higher( P < 0. 05). Correlation analysis showed that RDW were positively correlated with WBC,CRP,PCT and APACHEII scores in patients with acute pancreatitis( P < 0. 05).MPV were positively correlated with WBC,PCT. The levels of WBC,RDW,MPV,CRP,PCT and APACHEII could effectively predict SAP. The area under curve( AUC) was greater than 0. 5,and the AUC value of joint detection was 0. 995. Conclusion The level of RDW,MPV,WBC,CRP and PCT increased in patients with acute pancreatitis. The detection of RDW,MPV,WBC,CRP,PCT and APACHEII Score has a good application value in evaluating the condition and prognosis of acute pancreatitis.

关 键 词：急性胰腺炎 红细胞分布宽度 平均血小板体积 降钙素原 

分 类 号：R576[医药卫生—消化系统]