摘要
目的:探讨中性粒细胞与淋巴细胞比值(NLR)、血小板与淋巴细胞比值(PLR)、白细胞(WBC)、血淀粉酶(AMS)、尿淀粉酶(UAMY)、肝素结合蛋白(HBP)及降钙素原(PCT)对重症急性胰腺炎病人合并感染病情预测的临床应用价值,以及特异度及敏感度均较好的感染早期预测指标。方法:回顾性分析重症急性胰腺炎病人64例的临床资料,根据是否合并感染,将64例病人分为感染组34例及非感染组30例。于入院时采集静脉血检测NLR、PLR、WBC、AMS及PCT,采集病人尿液检测UAMY,并对检测数据进行对比分析。结果:非感染组和感染组中WBC、NLR、PLR、HBP、PCT水平差异均有统计学意义(P<0.01);2组AMS、UAMY水平差异均无统计学意义(P>0.05)。AMS和UAMY对诊断急性胰腺炎合并感染无统计学意义(P>0.05);WBC、NLR、PLR、HBP和PCT指标在采用敏感度、特异度及ROC曲线下面积(AUC)诊断均有统计学意义(P<0.05),其中敏感度由大到小为:PLR>PCT>NLR>HBP>WBC,特异度由大到小为:PCT>NLR>PLR>HBP>WBC,AUC由大到小为:PCT>HBP>PLR>NLR>WBC。结论:NLR、WBC、PLR、HBP及PCT的监测对重症急性胰腺炎合并感染的早期预测具有一定的临床价值,有助于对病情的判断及对后续治疗的指导。
Objective:To explore the clinical application value of neutrophil-lymphocyte ratio(NLR),platelet to lymphocyte ratio(PLR),white blood cell(WBC),blood amylase(AMS),urinary amylase(UAMY),heparin binding protein(HBP)and procalcitonin(PCT)in the evaluation of infection and severity of disease in patients with severe acute pancreatitis,and explore the infection markers with good specificity and sensitivity.Methods:The clinical data of 64 patients with severe acute pancreatitis were retrospectively analyzed.According to the incidence of co-infection,the 64 patients were divided into the infection group(34 cases)and the non-infection group(30 cases).On admission,venous blood was collected to detect NLR,PLR,WBC,AMS,HBP and PCT.Urine samples were collected to detect UAMY,and the data were analyzed.Results:There were significant differences in the levels of WBC,NLR,PLR,HBP and PCT between the non-infection group and the infection group(P<0.01).There was no significant difference in AMS and UAMY levels between the two groups(P>0.05).AMS and UAMY had no statistical significance in the diagnosis of acute pancreatitis complicated with infection(P>0.05).WBC,NLR,PLR,HBP and PCT had the statistical significance in the diagnosis of severe acute pancreatitis with sensitivity(PLR>PCT>NLR>HBP>WBC),specificity(PCT>NLR>PLR>HBP>WBC)and area under ROC curve(AUC)(PCT>HBP>PLR>NLR>WBC)(P<0.05).Conclusions:The monitoring of NLR,PLR,WBC,HBP and PCT has the important clinical value for the early prediction of severe acute pancreatitis complicated with infection,which is helpful to judge the condition and guide the follow-up treatment.
作者
王世杰
王振杰
邱兆磊
纪忠
赵亨
吴哲逸
张福龙
陶俊杰
程峰
WANG Shi-jie;WANG Zhen-jie;QIU Zhao-lei;JI Zhong;ZHAO Heng;WU Zhe-yi;ZHANG Fu-long;TAO Jun-jie;CHENG Feng(Department of Emergency Surgery,The First Affiliated Hospital of Bengbu Medical College,Bengbu Anhui 233004,China;Institute of Emergency and Critical Care Medicine,The First Affiliated Hospital of Bengbu Medical College,Bengbu Anhui 233004,China)
出处
《蚌埠医学院学报》
CAS
2022年第12期1643-1646,共4页
Journal of Bengbu Medical College
基金
安徽省教育厅自然科学研究项目(KJ2015B113by)
蚌埠医学院转化医学重点项目(BYTM2019017)
蚌埠医学院科技发展项目(BYKF1768)
睿E(睿意)急诊医学研究基金(R2018004)
蚌埠医学院研究生科研创新计划资助立项项目(Byycx20105)
蚌埠医学院自然科学重点项目(2021byzd054,2021byzd160)。
