初期生化指标对轻症急性胰腺炎预后的预测价值  

Predictive value of initial laboratory examination indicators for prognosis of mild acute pancreatitis

作　　者：席俊彦 肖杨 万圣洁 邱雨霞 汤银娟 王建钧[4] Xi Junyan;Xiao Yang;Wan Shengjie;Qiu Yuxia;Tang Yinjuan;Wang Jianjun(School of Public Health,Xiangnan University,Chenzhou,Hunan 423000,China;School of Clinical Medicine,Xiangnan University,Chenzhou,Hunan 423000,China;School of Basic Medicine,Xiangnan University,Chenzhou,Hunan 423000,China;Affiliated Hospital of Xiangnan University,Chenzhou,Hunan 423000,China)

机构地区：[1]湘南学院公共卫生学院 [2]湘南学院临床学院 [3]湘南学院基础医学院 [4]湘南学院附属医院,湖南郴州423000

出　　处：《感染．炎症．修复》2020年第1期30-35,共6页Infection Inflammation Repair

基　　金：湖南省教育厅项目(15C1276);湖南省教育厅优秀青年项目(16B245)。

摘　　要：目的:探讨急性胰腺炎发病初期生化指标对轻症急性胰腺炎预后的预测价值。方法:回顾性分析2015年1月—2017年12月湘南学院附属医院肝胆胰脾外科收治的77例轻症急性胰腺炎患者,初次发病24 h内取血和尿标本进行实验室检查,根据预后分为好转组、无效组和恶化组,并对组间15项实验室检查指标水平进行比较。结果:单因素方差分析结果显示,甘油三酯(TG)、胆固醇(TC)、高密度脂蛋白-胆固醇(HDL-C)、血淀粉酶(SAMY)、尿淀粉酶(UAMY)、直接胆红素(DBIL)、总胆红素(TBIL)、丙氨酸转氨酶(ALT)、天冬氨酸转氨酶(AST)、C-反应蛋白(CRP)、血糖、血钙水平的组间差异具有统计学意义(P<0.05)。多因素Logistic回归分析结果显示,TG、SAMY、CRP为轻症AP预后不良的独立危险因素,血钙为轻症AP预后不良的独立保护因素。TG、SAMY、CRP、血钙的ROC曲线截断值分别为1.26 mmol/L、234.28 U/L、24.40 mg/L、1.08 mmol/L。结论:急性胰腺炎患者初期TG、SAMY、CRP、血钙水平在预测疾病预后方面具有重要参考价值。Objective:To explore the predictive value of initial laboratory examination indicators for prognosis of mild acute pancreatitis.Methods:Clinical data of 77 patients with acute pancreatitis admitted to the Department of Hepatobiliary,Pancreatic and Splenic Surgery of the Affiliated Hospital of Xiangnan University from Jan.2015 to Dec.2017 were retrospectively analyzed.Serum and urine laboratory indicators were determined within 24 hours of primary onset.According to the prognosis,the patients were divided into improved group,unchanged group and worsened group.Difference of biomarkers between different groups were statistical analyzed.Results:The single factor variance analysis showed that the between-group differences in triglyceride(TG),total cholesterol(TC),high-density lipoprotein(HDL-C),serum amylase(SAMY),urine amylase(UAMY),direct bilirubin(DBIL),total bilirubin(TBIL),alanine aminotransferase(ALT),aspartate aminotransferase(AST),C-reactive protein(CRP),blood glucose(GLU),serum calcium(Ca)were statistically significant(P<0.05).TG,SAMY,CRP were independent risk factors,Ca was an independent protective factors of acute pancreatitis by multifactor logistic regression analysis.The cutoffs of ROC of TG,SAMY,CRP and Ca were 1.26 mmol/L,234.28 U/L,24.40 mg/L and 1.08 mmol/L.Conclusions:The levels of TG,SAMY,CRP and Ca may provide important reference value for prognostic prediction of early acute pancreatitis.

关 键 词：胰腺炎 急性 实验室检查指标 预后 预测价值 

分 类 号：R657.51[医药卫生—外科学]