LAP联合CRP、PCT对高甘油三酯型急性胰腺炎严重程度的预测研究  

Prediction of severity of hypertriglyceride acute pancreatitis with LAP combined with CRP and PCT

作　　者：汪奕潼 甘筠益 王晓龙[1] WANG Yitong;GAN Junyi;WANG Xiaolong(Department of Emergency Medicine,the Second Affiliated Hospital of Chongqing Medical University,Chongqing 400010,China)

机构地区：[1]重庆医科大学附属第二医院急救部,重庆400010

出　　处：《胃肠病学和肝病学杂志》2024年第10期1357-1361,共5页Chinese Journal of Gastroenterology and Hepatology

摘　　要：目的筛选高甘油三酯型急性胰腺炎(hypertriglyceridemic acute pancreatitis,HTGP)重症化的早期危险因素,探索联合预测指标,并评估其临床价值。方法纳入重庆医科大学附属第二医院2017年1月至2020年12月收治的290例HTGP患者为研究对象,依据病情严重程度分为重症急性胰腺炎(severe acute pancreatitis,SAP)组(n=84)、非SAP组(n=206),收集患者的一般资料、实验室检查指标、各项评分(APACHEⅡ评分、Ranson评分、CTSI评分和BISAP评分)等。通过纳入联合预测指标、脂质蓄积指数(lipid accumulation product,LAP)、CRP、PCT等因素进行多因素Logistic回归分析;并通过分析其ROC曲线,进一步评价联合预测指标的临床检验效能。结果SAP组腰围、血淀粉酶、TG、LAP等水平高于非SAP组,而SAP组年龄水平低于非SAP组,差异均有统计学意义(P<0.05);不同LAP四分位数样本对于是否重症有显著性差异(P<0.05),LAP与SAP的发生存在高强度相关。Logistic回归分析显示,Ranson、APACHEⅡ、CTSI及LAP与SAP发生风险呈正相关(P<0.05)。多因素Logistic回归分析提示,LAP分度每增加1单位,SAP发生风险将增加3.68倍(OR=3.680,P<0.001);分别绘制LAP、APACHEⅡ评分、Ranson评分、CTSI评分、BISAP评分预测SAP发生风险的ROC曲线,LAP预测SAP的AUC为0.846(95%CI:0.800~0.893),差异均有统计学意义(P<0.01)。结论HTGP患者的LAP与病情严重程度呈高强度正相关,LAP对SAP有良好的预测价值,联合LAP、CRP、PCT能进一步提高其预测效能。Objective To screen the early risk factors for the aggravation of hypertriglyceridemic acute pancreatitis(HTGP),explore the combined prediction indicators,and evaluate their clinical value.Methods A total of 290 HTGP patients admitted to the Second Affiliated Hospital of Chongqing Medical University from Jan.2017 to Dec.2020 were included as the research subjects and divided into the severe acute pancreatitis(SAP)group(n=84)and the non-SAP group(n=206)according to the severity of the disease.General data,laboratory indicators,and various scores(APACHEⅡscore,Ranson score,CTSI score and BISAP score)of the patients were collected.By including risk factors such as the combined prediction indicators,lipid accumulation product(LAP),CRP and PCT,a multivariate Logistic regression analysis was conducted.And by analyzing its ROC curve,the clinical testing efficacy of the combined prediction indicators was further evaluated.Results The levels of waist circumference(WC),blood amylase,triglyceride(TG),and LAP in the SAP group were higher than those in the non-SAP group,while the age level in the SAP group was lower than that in the non-SAP group,and the differences were statistically significant(P<0.05).Different LAP quartile samples showed significant differences in whether they were severe cases(P<0.05),and there was a high-intensity correlation between LAP and the occurrence of SAP.From the Logistic regression analysis,it is known that Ranson,APACHEⅡ,CTSI and LAP were positively correlated with the risk of SAP occurrence,and the results were statistically significant(P<0.05).The multivariate Logistic regression analysis indicated that for every 1-unit increase in the LAP grading,the risk of SAP occurrence would increase by 3.68 times,and the result was statistically significant(OR=3.680,P<0.001).The ROC curves of LAP,APACHEⅡ,Ranson score,CTSI score and BISAP score of the subjects for predicting the risk of SAP occurrence were drawn respectively.The AUC of LAP for predicting SAP was 0.846(95%CI:0.800-0.893),and all th

关 键 词：急性胰腺炎 高甘油三酯血症 重症化 危险因素 

分 类 号：R576[医药卫生—消化系统]