FAR、CAR和PLR对高脂血症性急性胰腺炎的预测价值  

Predictive value of FAR,CAR and PLR in hyperlipidemic acute pancreatitis

作　　者：王巧芳 梅超鹏 宋耀东[1] 刘艳娜 李德剑 崔梦巍 何倩倩[1] 李慧慧[1] 王海峰 朱长举[1] Wang Qiaofang;Mei Chaopeng;Song Yaodong;Liu Yanna;Li Dejian;Cui Mengwei;He Qianqian;Li Huihui;Wang Haifeng;Zhu Changju(Department of Emergency Medicine,the First Affiliated Hospital of Zhengzhou University,Henan Province Emergency and Trauma Engineering Research Center,Henan Province Key Laboratory of Emergency and Trauma Research Medicine,Zhengzhou 450052,Henan,China)

机构地区：[1]郑州大学第一附属医院急诊科,河南省急诊与创伤工程研究中心,河南省急诊与创伤研究医学重点实验室,郑州450052

出　　处：《中华急诊医学杂志》2024年第10期1376-1382,共7页Chinese Journal of Emergency Medicine

基　　金：河南省高等学校重点科研项目(23A320041);河南省医学科技攻关计划联合共建项目(LHGJ20220339)。

摘　　要：目的探讨纤维蛋白原与白蛋白比值(fi brinogen to albumin ratio,FAR)、肌酐与白蛋白比值(creatinine to albumin ratio,CAR)、血小板与淋巴细胞比值(platelet to lymphocyte ratio,PLR)预测高脂血症性急性胰腺炎(hyperlipidemic acute pancreatitis,HLAP)预后不良的价值。方法回顾性收集本院2021年1月至2023年12月收治的HLAP患者的临床资料,根据预后情况分为两组:预后良好组和预后不良组。采用多因素Logistic回归分析得出不同预后组HLAP的独立危险因素;绘制受试者工作特征曲线(receive operator characteristic curve,ROC),并评价FAR、CAR和PLR单独及联合指标对HLAP预后的预测价值。结果共纳入118例HLAP患者,其中预后良好组69例,预后不良组49例。两组间的心率、淋巴细胞、甘油三酯、白蛋白、肌酐、尿素氮、血钙、血糖、C-反应蛋白、降钙素原、纤维蛋白原、FAR、CAR、PLR、急性胰腺炎严重程度床旁指标评分、急性生理学与慢性健康状况评分、住院时间差异有统计学意义(P<0.05)。多因素Logistic回归分析显示,FAR(优势比(OR)=25.949,95%置信区间(95%CI):3.190~211.080,P=0.002)、CAR(OR=1.453,95%CI:1.095~1.928,P=0.010)、PLR(OR=1.005,95%CI:1.001~1.009,P=0.020)是HLAP患者预后不良的独立危险因素。ROC曲线分析显示:FAR、CAR、PLR单独指标预测HLAP患者预后不良的ROC曲线下面积AUC分别为0.823、0.781、0.652;FAR联合CAR、FAR联合PLR、CAR联合PLR的AUC分别为0.840、0.845、0.849;而FAR、CAR、PLR三者联合对HLAP患者预后不良的预测能力为(AUC=0.875,95%CI:0.814~0.937),其截断值为0.387,敏感度为83.7%,特异度为79.7%。结论FAR、CAR、PLR三者联合对HLAP患者预后不良的预测价值优于单独及两两联合的预测价值。Objective To investigate the value of fibrinogen to albumin ratio(FAR),creatinine to albumin ratio(CAR)and platelet to lymphocyte ratio(PLR)in predicting the poor prognosis of hyperlipidemic acute pancreatitis(HLAP).Methods Clinical data of HLAP patients admitted to the hospital from January 2021 to January and December 2023 were retrospectively collected.According to the prognosis,the patients were divided into two groups:good prognosis group and poor prognosis group.The independent risk factors of HLAP in different prognostic groups were obtained by multivariate Logistic regression analysis.Receiver operating characteristic(ROC)curves were plotted to evaluate the prognostic value of FAR,CAR and PLR alone and in combination.Results A total of 118 patients with HLAP were included,including 69 patients with good prognosis and 49 patients with poor prognosis.The difference of heart rate,lymphocyte,triglyceride,albumin,creatinine,urea nitrogen,blood calcium,blood glucose,C-reactive protein,procalcitonin,fibrinogen,FAR,CAR,PLR,Bedside indicator of acute pancreatitis Severity score,Acute Physiology and Chronic Health status score,hospitalization time assessment between the two groups was statistically significant(P<0.05).Multivariate Logistic regression analysis showed that FAR(odds ratio(OR)=25.949,95%confidence interval(95%CI):3.190~211.080,P=0.002),CAR(OR=1.453,95%CI:1.095~1.928,P=0.010)and PLR(OR=1.005,95%CI:1.001~1.009,P=0.020)were independent risk factors for poor prognosis in HLAP patients.ROC curve analysis showed that the area under the ROC curve(AUC)of FAR,CAR and PLR to predict poor prognosis of HLAP patients were 0.823,0.781 and 0.652,respectively.The AUC of FAR combined with CAR,FAR combined with PLR and CAR combined with PLR were 0.840,0.845 and 0.849,respectively.The combined ability of FAR,CAR and PLR to predict poor prognosis in HLAP patients was(AUC=0.875,95%CI:0.814~0.937).When the cut-off value was 0.387,the sensitivity was 83.7%,and the specificity was 79.7%.Conclusions The prognostic value of FAR

关 键 词：高脂血症 急性胰腺炎 纤维蛋白原与白蛋白比值 肌酐与白蛋白比值 血小板与淋巴细胞比值 预测 价值 预后不良 

分 类 号：R589.2[医药卫生—内分泌] R576[医药卫生—内科学]