血清血小板平均体积CRP纤维蛋白原与急性胰腺炎患者病情程度和预后转归的关系分析  

Analysis of the Relationship of Mean Platelet Volume C-Reactive Protein and Fibrinogen with the Severity and Prognosis of Acute Pancreatitis

作　　者：邓中波 叶淳娟 徐玉龙 DENG Zhongbo;YE Chunjuan;Xu Yulong(The Second People's Hospital of Anhui Province,Anhui Hefei 230011, China)

机构地区：[1]安徽省第二人民医院急诊科,安徽合肥230011

出　　处：《河北医学》2022年第4期670-675,共6页Hebei Medicine

基　　金：安徽省卫生和计划生育委员会科研计划项目,(编号:2018SEYL018)。

摘　　要：目的:探究血清平均血小板体积(MPV)、C-反应蛋白(CRP)、纤维蛋白原(FIB)与急性胰腺炎(AP)患者病情严重程度和预后转归的关系。方法:回顾性分析2017年4月至2021年4月我院88例AP患者资料,根据其病情严重程度分为轻度(MAP)组40例,中度(MSAP)组38例、重度(SAP)组10例,比较三组AP患者的MPV、CRP和FIB水平差异,并分析MPV、CRP、FIB与急性生理与慢性健康评分Ⅱ(APACHEⅡ)、Ranson评分、急性胰腺炎严重程度床边指数(BISAP)相关性。使用ROC曲线评估入院即刻MPV、CRP、FIB及其联合检测对AP预后的临床价值。结果:三组MPV、CRP水平比较,均为SAP组>MSAP组>MAP组(P<0.05),MSAP组和SAP组FIB水平均高于MAP组(P<0.05),但MSAP组和SAP组FIB水平比较无统计学差异(P>0.05)。入院即刻MPV、CRP、FIB水平均与APACHEⅡ评分、Ranson评分及BISAP评分均呈正相关(P<0.05)。入院即刻MPV、CRP、FIB对AP预后均具有较高的预测价值(AUC=0.658、0.668、0.725),其cut-off值分别为12.31 fL、84.26 mg/L、5.21 g/L,MPV、CRP、FIB3项联合对于AP患者预后的曲线下面积(AUC)值以及敏感度均明显高于MPV、CRP、FIB各单项检测价值。结论:血清MPV、CRP、FIB水平均与AP患者病情严重程度呈正相关,且三者联合可提高对患者预后的预测价值,对指导AP治疗有益。Objective:To explore the relationship of mean platelet volume(MPV),C-reactive protein(CRP)and fibrinogen(FIB)with the severity and prognosis of acute pancreatitis(AP).Methods:This study retrospectively analyzed the data of 88 patients with AP admitted to the hospital between April 2017 and April 2021.According to the severity of the disease,the patients enrolled were divided into mild(MAP)group(n=40),moderate(MSAP)group(n=38),and severe(SAP)group(n=10).The MPV,CRP and FIB levels in the 3 groups on admission were comparatively analyzed.The correlation of MPV,CRP and FIB with the Acute Physiologic and Chronic Health EvaluationⅡ(APACHEⅡ)score,Ranson score and Bedside Index of Severity in Acute Pancreatitis(BISAP)score was analyzed.The ROC curve was plotted to evaluate the clinical prognostic value of MPV,CRP and FIB on admission,and their joint detection in AP.Results:The MPV and CRP level decreased in order from SAP group,MSAP group to MAP group(P<0.05).The MSAP group and the SAP group had higher FIB levels than the MAP group(P<0.05).However,there was no significant difference in FIB level between the MSAP group and the SAP group(P>0.05).MPV,CRP and FIB levels on admission were positively correlated with APACHEⅡscore,Ranson score and BISAP score(P<0.05).MPV,CRP and FIB on admission were of high prognostic value in AP(AUC=0.658,0.668,0.725),and their cut-off values were 12.31 fL,84.265 mg/L,and 5.21 g/L.The area under the curve(AUC)value and sensitivity of combination of MPV,CRP and FIB3 for the prognosis of AP were significantly higher than those of MPV,CRP or FIB.Conclusion:Serum MPV,CRP and FIB are positively correlated with the severity of AP.Combination of the three can improve the prognosis of AP,which is conducive to guiding the treatment of AP.

关 键 词：急性胰腺炎 平均血小板体积 C-反应蛋白 纤维蛋白原 预后 

分 类 号：R54[医药卫生—心血管疾病]