基于BISAP和改良Glasgow评分的血液学指标在评估急性胰腺炎预后和严重程度中的临床价值研究  

Clinical value of hematological indexes based on BISAP and modified Glasgow score in evaluating the prognosis and severity of acute pancreatitis

作　　者：钟金金 高天 刘彬森 黄玲 徐石秀 Zhong Jinjin;Gao Tian;Liu Binsen;Huang Ling;Xu Shixiu(Shangyou County People's Hospital of Jiangxi Province,Ganzhou,Jiangxi 341200,China)

机构地区：[1]江西省上犹县人民医院,江西赣州341200

出　　处：《首都食品与医药》2023年第16期35-38,共4页Capital Food Medicine

摘　　要：目的探讨基于急性胰腺炎严重性床边指数(BISAP)和改良Glasgow评分(mGPS)的血液学指标在评估急性胰腺炎(AP)预后及严重程度中的价值。方法回顾性分析2020年7月-2022年6月江西省上犹县人民医院收治的84例AP患者及59例健康体检者临床资料,将84例AP患者设为观察组,将59例健康体检者设为对照组。经采血检测中性粒细胞与淋巴细胞比率(NLR)、血小板与淋巴细胞比率(PLR)、红细胞分布宽度(RDW)、白细胞计数(WBC)、C反应蛋白(CRP),比较两组间差异;并以BISAP评分及mGPS评分评估严重程度及预后,比较不同严重程度及预后患者血液学指标差异;绘制ROC曲线,分析NLR、PLR及联合检测预测重度AP及预后的临床价值。结果观察组NLR、PLR、RDW、CRP、WBC为(8.85±1.12)、(245.69±12.45)、(17.53±1.63)%、(22.35±2.34)mg/L、(19.85±2.12)×10^(9)/L,高于对照组,差异有统计学意义(P<0.05);经BISAP评分评估,观察组患者中有32例重度AP,52例轻度AP;重度AP患者NLR、PLR为(11.79±1.23)、(312.96±15.34),高于轻度AP患者,差异有统计学意义(P<0.05);经mGPS评分评估,观察组患者中有20例预后差,64例预后良好;预后差患者NLR、PLR为(16.79±1.53)、(372.96±18.63),高于预后良好患者,差异有统计学意义(P<0.05);绘制ROC曲线显示,NLR、PLR及联合检测预测重度AP的曲线下面积分别为:0.809、0.813、0.907,联合检测预测价值更高;绘制ROC曲线分析显示,NLR、PLR及联合检测预测AP预后的曲线下面积分别为:0.815、0.808、0.930,联合检测预测价值更高。结论基于BISAP及mGPS评分的血液学指标能良好地评估AP患者预后及严重程度,且操作简单、便捷,值得广泛应用。Objective To explore the value of hematological indexes based on acute pancreatitis severity bedside index(BISAP)and modified Glasgow score(mGPS)in evaluating the prognosis and severity of acute pancreatitis(AP).Methods The clinical data of 84 patients with AP and 59 patients with physical examination in our hospital from July 2020 to June 2022 were retrospectively analyzed.84 patients with AP were divided into observation group and 59 patients with physical examination were divided into control group.The neutrophil to lymphocyte ratio(NLR),platelet to lymphocyte ratio(PLR),red blood cell distribution width(RDW),white blood cell count(WBC)and C-reactive protein(CRP)were measured by blood sampling,and the differences between the two groups were compared;the severity and prognosis were evaluated by BISAP score and mGPS score,and the hematological indexes of patients with different severity and prognosis were compared;draw ROC curve,analyze the clinical value of NLR,PLR and combined detection in predicting severe AP and prognosis.Results The NLR,PLR,RDW,CRP and WBC of the observation group were(8.85±1.12),(245.69±12.45),(17.53±1.63)%,(22.35±2.34)mg/L,(19.85±2.12)×10^(9)/L,higher than the control group,the difference was statistically significant(P<0.05);32 cases of severe AP and 52 cases of mild AP were evaluated by BISAP score;the NLR and PLR of severe AP patients were(11.79±1.23)and(312.96±15.34),which were significantly higher than those of the mid AP group(P<0.05);according to the mGPS score,20 patients had poor prognosis and 64 patients had good prognosis;the NLR and PLR of patients with poor prognosis were(16.79±1.53)and(372.96±18.63),which were significantly higher than those of the good prognosis(P<0.05);the ROC curve shows that the area under the curve of NLR,PLR and joint detection to predict severe AP is 0.809,0.813 and 0.907 respectively,and the prediction value of joint detection is higher;the ROC curve analysis showed that the area under the curve of NLR,PLR and combined detection to predict

关 键 词：急性胰腺炎 血液学指标 预后 严重程度 预测价值 

分 类 号：R657.5[医药卫生—外科学]