红细胞分布宽度-白蛋白比值联合BISAP评分对急性胰腺炎严重程度及死亡率的预测价值  

Predictive value of red blood cell distribution width-to-albumin ratio combined with BISAP score for severity and mortality in acute pancreatitis

作　　者：吉茜茜 田尧 马林 钱进 Qianqian Ji;Yao Tian;Lin Ma;Jin Qian(Department of Gastroenterology,Hai′an People′s Hospital,Hai′an 226600,China)

机构地区：[1]海安市人民医院消化内科,江苏省226600

出　　处：《中华消化病与影像杂志（电子版）》2023年第6期433-438,共6页Chinese Journal of Digestion and Medical Imageology(Electronic Edition)

基　　金：江苏省高层次卫生人才“六个一工程”拔尖人才科研项目(LGY201918)。

摘　　要：目的探讨红细胞分布宽度(RDW)与血清白蛋白(ALB)比值联合急性胰腺炎床边严重程度指数(BISAP)对急性胰腺炎(AP)严重程度及30 d死亡率的预测价值。方法对2017年1月至2022年7月海安市人民医院收治的321例AP患者进行回顾性分析,确定AP的严重程度。通过受试者工作特征(ROC)曲线比较RDW/ALB、BISAP评分及两者联合对AP严重程度及30 d死亡率的预测价值。结果重症急性胰腺炎(SAP)占所有患者的18.7%(60/321),30 d内总死亡率为4.7%(15/321)。SAP组患者心率、呼吸频率、血糖、血清AST、ALT、尿素氮、血肌酐、RDW、血淀粉酶及BISAP评分均显著高于非SAP组(P<0.05),而血小板计数、血钙浓度和ALB显著低于非SAP组(P<0.05)。ROC曲线展示BISAP评分、RDW/ALB及两者联合预测SAP的曲线下面积(AUC)分别为0.751(95%CI 0.681~0.822),0.792(95%CI 0.726~0.858)和0.826(95%CI 0.760~0.892)。BISAP评分、RDW/ALB及联合预测30 d内死亡率的AUC分别为0.836(95%CI0.765~0.908)、0.816(95%CI0.740~0.892)和0.879(95%CI0.820~0.937)。结论RDW/ALB联合BISAP评分进一步提高了对AP严重程度及死亡风险的分层。Objective To evaluate the predictive value of red cell distribution width(RDW)-to-albumin(ALB)ratio combined with bedside index of severity in acute pancreatitis(BISAP)score for the severity and 30-day mortality in acute pancreatitis(AP).Methods A total of 321 AP patients admitted to Hai′an People′s Hospital from January 2017 to July 2022 were retrospectively analyzed,and the severity of AP was defined.The predictive values of RDW/ALB ratio,BISAP score and their combination for AP severity and 30-day mortality were evaluated by receiver operation characteristics(ROC)curves.Results Of 321 AP patients,60(18.7%)had severe acute pancreatitis(SAP)and the total mortality within 30 days was 4.7%(15/321).Compared with non-SAP group,the heart rate,respiratory rate,blood glucose,serum AST,ALT,blood urea nitrogen,serum creatinine level,RDW,amylase and BISAP score were higher(P<0.05),while platelet count,serum calcium and ALB were significantly lower in SAP group(P<0.05).ROC curves showed that the area under curve(AUC)values of BISAP score,RDW/ALB ratio and their combination for identifying SAP were 0.751(95%CI:0.681-0.822),0.792(95%CI:0.726-0.858)and 0.826(95%CI:0.760-0.892),respectively.In terms of 30-day mortality prediction,the AUC values for BISAP score,RDW/ALB ratio and their combination were 0.836(95%CI:0.765-0.908),0.816(95%CI:0.740-0.892)and 0.879(95%CI:0.820-0.937),respectively.Conclusion RDW/ALB ratio combined with BISAP score can further improve the risk stratification of AP severity and mortality.

关 键 词：急性胰腺炎 红细胞分布宽度 急性胰腺炎床边严重程度指数 死亡率 

分 类 号：R576[医药卫生—消化系统]