降钙素原、C-反应蛋白、中性粒细胞与淋巴细胞比值在评估急性胰腺炎严重程度和预后中的临床价值  

Clinical value of procalcitonin, C-reactive protein and neutrophil to lymphocyte ratio in assessing severity and prognosis of acute pancreatitis

作　　者：徐霞[1] 黄象维 赖媚媚[1] XU Xia;HUANG Xiang-wei;LAI Mei-mei(Department of Laboratory Medicine,the Second Affiliated Hospital of Wenzhou Medical University,Zhejiang 325027,China)

机构地区：[1]温州医科大学附属第二医院检验医学学科,浙江325027

出　　处：《中国卫生检验杂志》2022年第24期3032-3035,3042,共5页Chinese Journal of Health Laboratory Technology

摘　　要：目的 探讨降钙素原(PCT)、C-反应蛋白(CRP)、中性粒细胞与淋巴细胞比值(NLR)在评估急性胰腺炎严重程度和预后中的临床价值。方法 选择2020年11月—2021年12月在本院收治的121例急性胰腺炎患者作为研究对象,按疾病严重程度分为轻症组(MAP,n=52例)、中症组(MSAP,n=51例)和重症组(SAP,n=18例),另选取同期体检的50例健康体检者设为对照组。检测各组患者的PCT、CRP及NLR水平,将其与APACHE-Ⅱ评分和住院天数进行相关性分析,同时采用受试者工作曲线(ROC曲线)分析PCT、CRP及NLR水平在急性胰腺炎患者预后中的临床意义。结果 SAP组血清PCT、CRP、NLR水平及住院天数、APACHE-Ⅱ评分均高于MSAP组、MAP组,差异有统计学意义(P<0.05);MSAP组血清PCT、CRP水平均高于MAP组,差异有统计学意义(P<0.05);Pearson相关性分析结果显示,血清PCT、CRP水平与APACHE-Ⅱ评分成显著性正相关,NLR与APACHE-Ⅱ评分无相关性(P=0.194);ROC曲线分析显示,三者联合检测时其预测预后不良的AUC(0.800)高于血清PCT、CRP、NLR 3个指标单独检测,以PCT>0.12 ng/ml、CRP>194.7 mg/L、NLR>10.03为最佳截断值,3个指标单独检测时预测的特异度依次为94.4%、61.1%、50.0%,三者联合的特异度高于各指标单独检测(P<0.05)。结论 血清PCT、CRP水平与急性胰腺炎患者严重程度以及APACHE-Ⅱ评分具有密切相关性,与NLR联合应用在判断急性胰腺炎严重程度和评估预后方面有着重要的临床价值。Objective This paper aims to investigate the relationship between procalcitonin(PCT), C-reactive protein(CRP) and neutrophil to lymphocyte ratio(NLR) in evaluating the severity and the prognosis of acute pancreatitis. Methods One hundred and twenty-one patients with acute pancreatitis admitted to our hospital from November 2020 to December 2021 were selected as study subjects and divided into mild(MAP, n=52), moderate(MSAP, n=51) and severe(SAP, n=18) groups according to the severity of the disease, and another 50 healthy people from the same period of physical examination were selected and set as the control group. The levels of PCT, CRP and NLR in each group were measured and their correlation with APACHE-II score and hospitalization days was analyzed. Meanwhile, the clinical significance of PCT, CRP and NLR levels in the prognosis of patients with acute pancreatitis was analyzed by using subject work curve(ROC curve). Results The serum levels of PCT, CRP and NLR, days of hospitalization, and APACHE-II scores were higher in the SAP group than that in the MSAP group and the MAP group, and the differences were statistically significant(P<0.05);the serum PCT and CRP levels were higher in the MSAP group than that in the MAP group, and the differences were statistically significant(P<0.05). Pearson correlation analysis showed that serum PCT and CRP levels were positively correlated with APACHE-II score, while NLR was not correlated with APACHE-II score(P=0.194);ROC curve analysis showed the AUC(0.800)for predicting poor prognosis was higher than that of individual PCT, CRP and NLR, and the best cut-off values were PCT>0.12 ng/ml, CRP>194.7 mg/L and NLR>10.03. The specificity of the three indicators was 94.4%, 61.1%, and 50.0% in order, and the specificity of the combination of the three indicators was higher than that of each individual indicator(P<0.05). Conclusion Serum PCT and CRP levels are closely correlated with the severity of patients with acute pancreatitis and APACHE-II scores, and their combined applicati

关 键 词：降钙素原 C-反应蛋白 中性粒细胞与淋巴细胞比值 急性胰腺炎 

分 类 号：R446[医药卫生—诊断学]