血清PCT、CRP、D-D、铁水平与急性胰腺炎病情严重程度的相关性及其联合检测对患儿预后的预测价值  

Correlation of serum PCT,CRP,D-D,iron levels at admission with the severity of acute pancreatitis and the predictive value of their combined detection for the prognosis of children with acute pancreatitis

作　　者：龚灵辉 李艳华 史笑敏 陈丽 GONG Ling-hui;LI Yan-hua;SHI Xiao-min;CHEN Li(The Second Department of Pediatric Internal Medicine,Zhumadian Central Hospital,Zhumadian 463000,Henan,CHINA)

机构地区：[1]驻马店市中心医院小儿内二科,河南驻马店463000

出　　处：《海南医学》2025年第5期703-707,共5页Hainan Medical Journal

基　　金：2021年度河南省医学科技攻关计划联合共建项目(编号:LHGJ20213651)。

摘　　要：目的探讨入院时降钙素原(PCT)、C反应蛋白(CRP)、D-二聚体(D-D)、血清铁水平与急性胰腺炎(AP)患儿病情严重程度的相关性及其联合检测对患儿预后的预测价值。方法回顾性分析2021年1月至2023年1月驻马店市中心医院收治的117例AP患儿的临床资料,根据病情严重程度分为轻症组47例、中症组38例和重症组32例。比较三组患儿入院时的血清PCT、CRP、D-D和铁水平,采用Spearman分析入院时血清PCT、CRP、D-D、铁水平与AP病情严重程度的相关性;所有患儿给予对症支持治疗,并进行随访。根据随访结果,将117例患儿分为预后良好组81例和预后不良组36例。比较两组患儿入院时的血清PCT、CRP、D-D和铁水平,采用受试者工作特征(ROC)曲线分析入院时血清PCT、CRP、D-D、铁水平联合检测对AP患儿预后不良的预测价值。结果重症组患儿入院时的血清PCT、CRP、D-D水平分别为(4.17±0.96)ng/mL、(158.91±13.22)mg/L、(3.69±0.87)mg/L,中症组分别为(2.56±0.83)ng/mL、(103.04±10.95)mg/L、(1.90±0.51)mg/L,轻症组分别为(1.62±0.43)ng/mL、(72.36±7.71)mg/L、(1.59±0.46)mg/L,重症组>中症组>轻症组,两两比较差异均有统计学意义(P<0.05);重症组患儿入院时血清铁水平为(4.75±1.16)μmol/L,中症组为(10.29±3.55)μmol/L,轻症组为(15.68±4.74)μmol/L,重症组<中症组<轻症组,两两比较差异有统计学意义(P<0.05)。Spearman相关性分析结果显示,入院时血清PCT、CRP、D-D水平与AP患儿病情严重程度呈正相关(r=0.694、0.801、0.765),血清铁水平与AP患儿病情严重程度呈负相关(r=-0.734,P<0.05)。预后不良组患儿入院时的血清PCT、CRP、D-D水平明显高于预后良好组,血清铁水平明显低于预后良好组,差异均有统计学意义(P<0.05)。ROC曲线分析结果显示,血清PCT、CRP、D-D、铁水平联合检测预测AP患儿预后不良的AUC为0.940,明显大于上述指标单独检测的0.740、0.800、0.762、0.824(P<0.05)。结论�Objective To investigate the correlation of serum procalcitonin(PCT),C-reactive protein(CRP),D-dimer(D-D),serum iron levels at admission with the severity of acute pancreatitis(AP)in children and evaluate the predictive value of combined detection for the prognosis of AP children.Methods A total of 117 children with AP admitted to Zhumadian Central Hospital from January 2021 to January 2023 were retrospectively selected and divided into a mild group(47 cases),a moderate group(38 cases),and a severe group(32 cases)according to the severity of their condition.The serum PCT,CRP,D-D,and iron levels at admission were compared among the three groups.The correlation of serum PCT,CRP,D-D,and iron levels at admission with the severity of AP was analyzed by Spearman analysis.All AP patients were given symptomatic supportive treatment and followed up.According to the follow-up results,the 117 children were divided into good prognosis(81 cases)and poor prognosis(36 cases)subgroups,and serum PCT,CRP,D-D,and iron levels at admission were compared between the two subgroups.Receiver operating characteristic(ROC)curve was used to analyze the predictive value of combined detection of serum PCT,CRP,D-D,and iron levels at admission for poor prognosis in children with AP.Results Serum PCT,CRP,and D-D levels at admission increased with disease severity(the severe group>the moderate group>the mild group,all P<0.05):severe group,PCT(4.17±0.96)ng/mL,CRP(158.91±13.22)mg/L,and D-D(3.69±0.87)mg/L;moderate group,(2.56±0.83)ng/mL,(103.04±10.95)mg/L,and(1.90±0.51)mg/L;mild group,(1.62±0.43)ng/mL,(72.36±7.71)mg/L,and(1.59±0.46)mg/L.Serum iron levels at admission decreased with severity:(4.75±1.16)μmol/L in severe group,(10.29±3.55)μmol/L in moderate group,and(15.68±4.74)μmol/L in mild group,with statistically significant differences(P<0.05).Spearman correlation analysis results showed that the serum PCT,CRP,and D-D levels at admission were positively correlated with the severity of AP children(r=0.694,0.801,0.765;P<0.05),while se

关 键 词：急性胰腺炎 降钙素原 C反应蛋白 D-二聚体 血清铁 预后 相关性 预测价值 

分 类 号：R657.51[医药卫生—外科学]