摘要
目的探讨Balthazar CT评分与D-二聚体预测急性胰腺炎(AP)并发门静脉系统血栓(PVST)的价值。方法回顾性分析2017年6月—2021年2月徐州医科大学附属沭阳医院收治的217例AP患者的临床资料。统计住院期间AP并发PVST情况;对比并发PVST组及未并发PVST组基本资料;回顾性分析影响AP患者并发PVST的因素;以受试者工作特征(ROC)曲线下面积(AUC)评估AP患者Balthazar CT评分、D-二聚体并预测PVST发生的价值。结果剔除4例,剩余213例AP患者中有9.86%并发PVST。并发PVST组急性生理学及慢性健康状况评分Ⅱ(APACHEⅡ)、TC、脂肪酶、膀胱压、血氧分压、Balthazar CT评分、C反应蛋白、淀粉酶、凝血酶原时间、D-二聚体水平均高于未并发PVST组(P<0.05)。Logistic回归多因素分析显示Balthazar CT评分、凝血酶原时间、D-二聚体是影响AP患者并发PVST的影响因素(P<0.05)。ROC曲线分析显示Balthazar CT评分、D-二聚体及二者联合预测AP患者并发PVST的AUC分别为0.802、0.771、0.900。结论AP患者并发PVST风险高,AP并发PVST患者Balthazar CT评分、D-二聚体异常升高,Balthazar CT评分、D-二聚体对AP患者并发PVST具有一定预测效能。
Objective To explore the value of Balthazar CT score and D-dimer in predicting acute pancreatitis(AP)complicated by portal venous system thrombosis(PVST).Methods The clinical data of 217 AP patients admitted to Shuyang Hospital of Xuzhou Medical University from June 2017 to February 2021 were retrospectively analyzed.During the hospitalization,AP concurrent PVST was counted.They weredivided into 2 groups:concurrent PVST group and the non-concurrent PVST group according to the PVST incidence.The clinical data were collected and retrospectively analyzed to identify the factors affecting PVST.Factors affecting PVST in AP patients were retrospectively analyzed.Receiver operating characteristic(ROC)area under the curve(AUC)was used to evaluate the values of Balthazar CT score and D-dimer in predicting the occurrence of PVST in AP patients.Results 4 cases were eliminated.9.86%of the rest 213 AP patients had PVST.The APACHEⅡscore,Balthazar CT score,and levels of TC,lipase,bladder pressure,blood oxygen pressure,C-reactive protein,amylase,prothrombin time,and D-dimer in the complicated PVST group were all significantly higher than the non-complicated PVST group(all P<0.05).Logistic regression multivariate analysis showed that Balthazar CT score,prothrombin time,and D-dimer were the influencing factors of PVST in AP patients(all P<0.05).ROC curve analysis showed that the Balthazar CT score,D-dimer level and the combination of the two predicted the AUC of AP patients with PVST were 0.802,0.771,0.900,respectively.Conclusion AP patients are at high risk of PVST.In AP patients with PVST,Balthazar CT score and D-dimer are abnormally increased.Balthazar CT score and D-dimer have certain predictive power for AP patients with PVST.
作者
杨溪
陈晨
王雷鸣
叶松
孙强虎
YANG Xi;CHEN Chen;WANG Leiming;YE Song;SUN Qianghu(Department of General Surgery,Shuyang Hospital Affiliated to Xuzhou Medical University,Suqian Jiangsu 223600,China)
出处
《中国急救复苏与灾害医学杂志》
2022年第9期1198-1201,共4页
China Journal of Emergency Resuscitation and Disaster Medicine
