系统性炎症反应指数早期预测重症急性胰腺炎的价值  

Value of systemic inflammatory response index in the early prediction of severe acute pancreatitis

作　　者：何景梅 邵兴 王生超 陈琨 HE Jingmei;SHAO Xing;WANG Shengchao;CHEN Kun(Department of Intensive Care Unit,Jinhua Central Hospital(Affiliated Jinhua Hospital,Zhejiang University Schoool of Medicine),Jinhua 321000,China)

机构地区：[1]金华市中心医院(浙江大学医学院附属金华医院)重症医学科,321000

出　　处：《浙江医学》2025年第3期301-304,共4页Zhejiang Medical Journal

基　　金：金华市中医药科学技术研究计划项目(2019jzk015)。

摘　　要：目的探讨系统性炎症反应指数(SIRI)早期预测重症急性胰腺炎(AP)的价值。方法回顾性选取2020年1月至2023年12月在金华市中心医院就诊的102例AP患者为研究对象。根据病情严重程度将患者分为轻症组48例和重症组54例。比较两组患者一般资料、入院时实验室检测指标、急性生理学和慢性健康状况评价(APACHE)Ⅱ评分、氧合指数和SIRI的差异,采用ROC曲线评估差异指标早期预测重症AP的效能。结果重症AP患者入院时SIRI、APACHEⅡ评分均高于轻症AP患者,差异均有统计学意义(均P<0.05)。ROC曲线分析显示,SIRI、APACHEⅡ评分预测重症AP的AUC为0.799、0.747,两者比较差异无统计学意义(P=0.634)。SIRI的截断值为3.265×10^(9)/L,灵敏度为0.788,特异度为0.765。结论SIRI在早期预测重症AP方面具有一定的参考价值。当AP患者SIRI>3.265×10^(9)/L时,就应当考虑其有发展为重症AP的倾向,该指标可用于甄别高危人群。Objective To assess the utility of the systemic inflammatory response index(SIRI)as a prognostic indicator for early identification of severe acute pancreatitis(SAP).Methods From January 1,2020 to December 31,2023,a total of 102 cases of hospitalized patients with acute pancreatitis were collected at Jinhua Central Hospital,comprising 48 mild cases and 54 severe cases.Patients in the mild and severe groups were compared in general information,laboratory test indices at admission to the hospital,Acute Physiology and Chronic Health Evaluation(APACHE)ⅡScore,oxygenation index and SIRI.ROC curve was used to determine the predictive performance of the significantly differing indices in early identification of SAP.Results Upon admission,patients with SAP exhibited higher levels of the SIRI and APACHEⅡScore compared to patients in the mild group,with statistically significant differences(both P<0.05).ROC curve analysis demonstrated that the AUC of SIRI and APACHEⅡScore for predicting SAP were 0.799 and 0.747,respectively.There was no statistically significant difference between the two groups(P=0.634).The optimal cut-off value for the SIRI was determined to be 3.265×10^(9)/L,demonstrating a sensitivity of 0.788 and a specificity of 0.765.Conclusion SIRI has certain reference value in the early prediction of SAP.A SIRI value exceeding 3.265×10^(9)/L in individuals with acute pancreatitis warrants consideration for the trend of progressing to SAP,which can aid in the identification of high-risk patient populations.

关 键 词：系统性炎症反应指数 重症急性胰腺炎 价值 

分 类 号：R576[医药卫生—消化系统]