血清D-二聚体联合C反应蛋白与白蛋白比值与急性胰腺炎早期严重程度的相关性分析  

Correlation analysis of serum D-dimer combined C-reactive protein to albumin ratio with early severity of acute pancreatitis

作　　者：陈庆坤 童钟[2] CHEN QingKun;TONG Zhong(Department of Graduate School,Bengbu Medical University,Bengbu 233000,China;Department of Hepatobiliary Surgery,The First People's Hospital of Hefei)

机构地区：[1]蚌埠医科大学研究生院,安徽蚌埠233000 [2]合肥市第一人民医院肝胆胰外科

出　　处：《沈阳医学院学报》2025年第1期61-65,共5页Journal of Shenyang Medical College

基　　金：合肥市卫生健康应用医学研究重点项目(No.Hwk2021zd004)。

摘　　要：目的:研究急性胰腺炎(AP)患者血清D-二聚体(DD)、C反应蛋白(CRP)及白蛋白(ALB)水平,并探讨DD与CRP与ALB比值(CRP/ALB)在评估AP严重程度方面的潜在价值。方法:选取2022年1月至2023年12月在合肥市第一人民医院接受治疗的88例AP患者。依据修订后的亚特兰大分类标准,将患者分为轻症急性胰腺炎(MAP,共39例)、中度重症急性胰腺炎(MSAP,共24例)以及重症急性胰腺炎(SAP,共25例) 3组。选取该院同期25例甲状腺良性肿瘤患者为对照组。比较AP组以及对照组血清DD、CRP和ALB水平以及CRP/ALB值,采用受试者工作特征(ROC)曲线评估DD、CRP和ALB单独预测以及DD与CRP/ALB比值联合预测AP患者病情严重程度的有效性。结果:对照组患者的血清DD和CRP水平显著低于,而ALB水平则明显高于AP组(P<0.01)。此外,在AP组中,入院时间≤12 h的患者血清DD和CRP水平显著低于,而ALB水平显著高于>12 h入院患者(P<0.01)。MAP组血清DD、CRP水平及CRP/ALB值低于MSAP组和SAP组,MSAP组血清DD、CRP水平及CRP/ALB值低于SAP组;MAP组血清ALB水平高于MSAP组和SAP组,MSAP组血清ALB水平高于SAP组,差异均有统计学意义(P<0.05)。血清DD、CRP和ALB在预测AP患者病情严重程度方面的ROC曲线下面积分别为0.741、0.737和0.642;当DD与CRP/ALB比值结合使用时,其ROC曲线下面积为0.812。结论:血清DD、CRP水平以及ALB对于早期评估AP患者的病情严重程度具有一定的临床意义,且DD联合CRP/ALB值的预测效果优于单独使用这些指标。Objective:To investigate the value of serum D-dimer(DD),C reactive protein(CRP),albumin(ALB),and DD combined CRP/ALB ratio in predicting the severity of acute pancreatitis(AP).Method:A total of 88 AP patients admitted to Hefei First People's Hospital from Jan 2022 to Dec 2023 were enrolled.AP patients were divided into mild AP(MAP)group(39 cases),moderately severe AP(MSAP)group(24 cases)and severe AP(SAP)group(25 cases)according to the revised Atlanta Classification.A total of 25 patients with benign thyroid tumors were selected as the control group.Serum levels of DD,CRP,ALB and CRP/ALB ratio were compared between AP group and the control group.Receiver operating characteristics(ROC)curves were used to evaluate the efficacy of DD,CRP,and ALB alone and the combined DD and CRP/ALB ratio in predicting disease severity of AP.Results:The serum levels of DD and CRP in the control group were signi ficantly lower than those in the AP group,and the level of ALB was significantly higher than that in the AP group(P<0.01).In addition,in the AP group,the serum levels of DD and CRP in patients admitted≤12 h were significantly lower than those in patients admitted>12 h,and the ALB level was significantly increased(P<0.01).The serum levels of DD,CRP and CRP/ALB ratio in MAP group were significantly lower than those in MSAP group and SAP group,and those in MSAP group was lower than those in SAP group(P<0.05).The serum level of ALB in MAP group were significantly higher than those in MSAP group and SAP group,and the serum level of ALB in MSAP group was significantly higher than that in SAP group(P<0.05).The areas under ROC curve of serum DD,CRP and ALB and DD combined with CRP/ALB ratio in predicting the severity of AP patients were 0.741,0.737,0.642 and 0.812,respectively.Conclusions:Serum DD,CRP and ALB levels have certain significance in the assessment of the severity of early AP disease.The prediction effect of DD combined with CRP/ALB ratio is better than that of these indicators alone.

关 键 词：D-二聚体 C反应蛋白与白蛋白比值 急性胰腺炎 

分 类 号：R576[医药卫生—消化系统]