乳酸脱氢酶与白蛋白比值对急性胰腺炎严重程度的预测价值  

Predictive value of lactate dehydrogenase to albumin ratio onseverity of acute pancreatitis

作　　者：郭硕 吴文博 袁晨晨 吴克艳 路国涛[1] 潘佳佳 肖炜明 孙云云[1] GUO Shuo;WU Wenbo;YUAN Chenchen;WU Keyan;LU Guotao;PAN Jiajia;XIAO Weiming;SUN Yunyun(Department of Gastroenterology,Affiliated Hospital of Yangzhou University,Yangzhou,Jiangsu 225000,China;Yangzhou Key Laboratory of Pancreatic Diseases,Yangzhou,Jiangsu 225000,China)

机构地区：[1]扬州大学附属医院消化内科,江苏扬州225000 [2]扬州市胰腺病重点实验室,江苏扬州225000

出　　处：《重庆医学》2023年第18期2745-2750,共6页Chongqing medicine

基　　金：国家自然科学基金项目(82270680,82200721);江苏省扬州市政策引导类计划(国际科技合作)项目(YZ2022207);江苏省扬州市胰腺病重点实验室项目(YZ2021147)。

摘　　要：目的 探讨乳酸脱氢酶与白蛋白比值(LAR)对急性胰腺炎(AP)严重程度的预测价值。方法 回顾性分析2013-2020年扬州大学附属医院消化内科诊治AP患者的临床资料,依据2012年修订版亚特兰大分类将患者分为非重症急性胰腺炎组(非SAP组)和重症急性胰腺炎组(SAP组)。收集所有入组患者的一般临床资料和实验室检查指标,计算LAR、中性粒细胞与淋巴细胞比值(NLR)、血小板与淋巴细胞比值(PLR)、预后营养指数(PNI)。采用Spearman相关性分析,logistic回归分析SAP的危险因素。绘制受试者工作特征(ROC)曲线,分析各指标对SAP的预测价值。结果 相较于非SAP组患者,SAP组患者的LAR、白细胞计数(WBC)、空腹血糖(GLU)、门冬氨酸氨基转移酶(AST)、乳酸脱氢酶(LDH)水平明显升高,差异有统计学意义(P<0.05)。LAR与吸烟、饮酒呈负相关(P<0.05),与性别、年龄、亚特兰大分类、WBC、丙氨酸氨基转移酶(ALT)、AST、谷氨酰转肽酶(GGT)及既往有胆囊炎、胆结石病史等呈正相关(P<0.05)。logistic回归分析显示LAR为AP严重程度的独立危险因素。LAR预测SAP的AUC为0.705(95%CI:0.664~0.744,P<0.001),高于LDH、白蛋白(ALB)、NLR、PLR、PNI的AUC(0.694、0.538、0.650、0.634、0.592)。结论 LAR在早期评估AP严重程度时有较好的预测价值。Objective To investigate the predictive value of the Lactate dehydrogenase to Albumin ratio(LAR)on the severity of acute pancreatitis(AP).Methods The clinical data of AP patients diagnosed and treated in the Department of Gastroenterology,Affiliated Hospital of Yangzhou University from 2013 to 2020 were retrospectively analyzed.And the patients were divided into the non-severe acute pancreatitis group(Non-SAP group)and the severe acute pancreatitis group(SAP group)according to the Atlanta Classification(2012 revision).The general clinical data and laboratory examination indexes were collected from all enrolled patients,and LAR,neutrophil-lymphocyte ratio(NLR),platelet-lymphocyte ratio(PLR)and prognosis nutrition index(PNI)values were calculated.Spearman correlation analysis and logistic regression were used to analyze the risk factors of SAP.The receiver operating characteristic curve(ROC)was drew to analyze the predictive value of each index to SAP.Results Compared with the Non-SAP group,the levels of LAR,WBC,fasting blood glucose(GLU),aspartate aminotransferase(AST)and lactate dehydrogenase(LDH)in the SAP group were significantly h igher,and the difference was statistically significant(P<0.05).LAR was negatively correlated with smoking and drinking(P<0.05),and positively correlated with sex,age,Atlanta classification,WBC,alanine aminotransferase(ALT),AST,glutamyl transpeptidase(GGT)and previous history of cholecystitis and gallstones(P<0.05).Logistic regression analysis showed that LAR was an independent risk factor for AP severity.LAR predicted that the area under the curve(AUC)of SAP was 0.705(95%CI:0.664-0.744,P<0.001),which was higher than that of LDH,ALB,NLR,PLR and PNI(0.694,0.538,0.650,0.634 and 0.592).Conclusion LAR has good predictive value in early assessment of AP severity.

关 键 词：急性胰腺炎 乳酸脱氢酶与白蛋白比值 炎症指标 严重程度 预测价值 

分 类 号：R576[医药卫生—消化系统]