NLPR、hsCRP/PA、PCT联合检测对重症急性胰腺炎的预测价值  

Study on the predictive value of NLPR,hsCRP/PA,PCT combined detection for severe acute pancreatitis

作　　者：王俊 胡莲[1] 刘诗 王文兵[1] 陈澄 WANG Jun;HU Lian;LIU Shi;WANG Wenbing;CHEN Cheng(Department of Gastroenterology,The First People's Hospital of Yibin,Yibin 644000,Sichuan,China;Department of Gastroenterology,Union Hospital of Tongji Medical College,Huazhong University of Science and Technology,Wuhan 430022,China;Department of Nephrology,The Fifth Affiliated Hospital of Sun Yat-sen University,Zhuhai 519000,Guangdong,China)

机构地区：[1]宜宾市第一人民医院消化内科,四川宜宾644000 [2]华中科技大学同济医学院附属协和医院消化内科,湖北武汉430022 [3]中山大学附属第五医院肾病内科,广东珠海519000

出　　处：《西部医学》2024年第3期427-432,共6页Medical Journal of West China

基　　金：宜宾市第一人民医院2022年第一次院级科研课题(2022-KYY-01)。

摘　　要：目的 探讨中性粒细胞与淋巴细胞和血小板比值(NLPR)、超敏C反应蛋白(hsCRP)/前白蛋白(PA)、降钙素原(PCT)与重症急性胰腺炎(SAP)的相关性,并分析上述3个指标单独及联合检测对SAP的预测价值。方法 选取2016年2月—2022年1月宜宾市第一人民医院收治的急性胰腺炎(AP)患者205例,按病情严重程度分为非SAP组(n=155)和SAP组(n=50)。比较两组一般临床特征及评分,进行单因素分析,应用二元Logistic回归对NLPR、hsCRP/PA、PCT进行分析,比较联合预测因子、BISAP及Ranson评分预测价值。结果 二元Logistic回归分析发现NLPR、hsCRP/PA、PCT均为预测SAP的独立影响因素;ROC曲线结果显示,NLPR曲线下面积为0.68,最佳阈值为4.73;PCT曲线下面积为0.93,最佳阈值为0.39;hsCRP/PA曲线下面积为0.82,最佳阈值为0.44;联合预测因子曲线下面积为0.94,最佳阈值为0.13;联合预测因子的灵敏度及阴性预测率高于Ranson评分及BISAP评分。结论 NLPR、hsCRP/PA、PCT各指标在一定程度上可反映AP严重程度,可被视为早期预测SAP的指标,其联合预测因子具有较好的临床应用价值。Objective To investigate the correlation between neutrophil to lymphocyte and platelet ratio(NLPR),high sensitivity C-reactive protein(hsCRP)/prealbumin(PA),procalcitonin(PCT) and severe acute pancreatitis(SAP) and nalyze the predictive value of the three indicators for SAP when they are detected individually and jointly.Methods A total of 205 patients with acute pancreatitis(AP) admitted to the First People′s Hospital of Yibin City from February 2016 to January 2022 were selected,and the information and data were collected and analyzed statistically.Results Binary Logistic regression analysis found that NLPR,hsCRP/PA,and PCT were all independent influencing factors for SAP prediction.The ROC curve results showed that the area under the NLPR curve was 0.68,and the optimal threshold was 4.73;the area under the PCT curve was 0.93,the optimal threshold is 0.39.The area under the hsCRP/PA curve is 0.82,and the optimal threshold is 0.44;the area under the curve of the joint predictor is 0.94,and the optimal threshold is 0.13.The combined predictor has higher sensitivity and negative prediction rate than Ranson score and BISAP score.Conclusion NLPR,hsCRP/PA,and PCT are independent predictors of SAP,to some extent,which can reflect the severity of AP and be utilized as markers for early SAP prediction;the combined predictor has a good clinical application value.

关 键 词：急性重症胰腺炎 中性粒细胞与淋巴细胞和血小板比值 超敏C反应蛋白/前白蛋白 降钙素原 联合预测因子 

分 类 号：R657.51[医药卫生—外科学]