摘要
目的:探讨胆源性胰腺炎患者血清C反应蛋白(CRP)、淀粉酶(AMY)、平均血小板体积(MPV)的变化及其临床意义。方法:选取黄山市人民医院2019年6月至2022年6月收治的98例急性胆源性胰腺炎患者(胆源组)、同期确诊的急性非胆源性胰腺炎患者100例作为对照组,对比两组患者的CRP、AMY、MPV水平,并对比两组丙氨酸氨基转移酶(ALT)、天门冬氨酸氨基转移酶(AST)、总胆红素(TBIL)、直接胆红素(DBIL)、白细胞(WBC)、血糖、血钙、乳酸脱氢酶、血红蛋白、血细胞压积、血小板计数、急性生理功能与慢性健康(APACHEⅡ)评分、CT严重指数评分(CTSI);并采用简单线性相关方式分析CRP、AMY、MPV水平与患者APACHEⅡ评分、CTSI的相关性。结果:对比胆源组和对照组的血清CRP、AMY测定值水平,两组之间差异均不具有统计学意义(P>0.05);胆源组的外周血MPV测定值高于对照组,上述指标的组间差异有统计学意义(P<0.05);胆源组患者的血清ALT、AST、TBIL、DBIL测定值高于对照组,上述指标的组间差异有统计学意义(P<0.05);胆源组和对照组患者的尿素氮、WBC、血糖、血钙、乳酸脱氢酶、血红蛋白、血细胞压积、血小板计数、APACHEⅡ评分、CTSI评分比较,差异不具有统计学意义(P>0.05);胆源组患者的CRP、AMY、MPV与APACHEⅡ评分、CTSI评分进行相关性分析,结果显示均呈显著的正相关关系(P<0.05);外周血中MPV水平在鉴别诊断急性胆源性胰腺炎或急性非胆源性胰腺炎患者方面价值较高,灵敏度为70.63%、特异度为64.75%、AUC值为0.746(95%CI:0.679~0.813),截断值为≥9.20fL。结论:急性胆源性胰腺炎或急性非胆源性胰腺炎患者的CRP、AMY水平差异不大,MPV高于急性非胆源性胰腺炎患者,CRP、AMY、MPV与急性胆源性胰腺炎患者病情严重程度有关,MPV在鉴别诊断急性胆源性胰腺炎或急性非胆源性胰腺炎患者中有一定的价值。
Objective:To investigate the changes and clinical significance of serum C-reactive protein(CRP),amylase(AMY),and mean platelet volume(MPV)in patients with biliary pancreatitis.Methods:Ninety eight patients with acute biliary pancreatitis(biliary source group)and 100 patients with acute non biliary pancreatitis(control group)diagnosed at the same time in Huangshan People's Hospital from June 2019 to June 2022 were selected.The levels of CRP,AMY,MPV,liver function indicators,blood routine biochemical indicators,acute physiological function and chronic health(APACHE II)scores,and CT severity index scores(CTSI)of the two groups were compared.Simple linear correlation was used to analyze the correlation between CRP,AMY,MPV levels,APACHEⅡscore and CTSI.Results:There was no statistically significant difference between the two groups in serum CRP and AMY measured values(P>0.05);the measured value of MPV in peripheral blood of the biliary group was higher than that of the control group,and the difference between the above indexes was statistically significant(P<0.05);the serum ALT,AST,TBIL and DBIL of patients in the biliary group were higher than those in the control group,and the difference between the above indexes was statistically significant(P<0.05);there was no statistically significant difference in urea nitrogen,WBC,blood sugar,blood calcium,lactate dehydrogenase,hemoglobin,hematocrit,platelet count,APACHEⅡscore and CTSI score between the biliary group and the control group(P>0.05);the correlation analysis of CRP,AMY,MPV,APACHEⅡscore and CTSI score of patients in biliary group showed that there was significant positive correlation(P<0.05);the level of MPV in peripheral blood has high value in differential diagnosis of patients with acute biliary pancreatitis or acute non biliary pancreatitis,with sensitivity of 70.63%,specificity of 64.75%,AUC value of 0.746(95%CI:0.679-0.813),and cutoff value of≥9.20 fL.Conclusion:The levels of CRP and AMY in patients with acute biliary pancreatitis or acute non-biliary
作者
花雷
魏伟
杜勇
王煜
HUA Lei;WEI Wei;DU Yong(Huangshan People's Hospital,Anhui Huangshan 245000,China)
出处
《河北医学》
CAS
2023年第6期972-977,共6页
Hebei Medicine
基金
安徽省卫生健康委科研项目,(编号:AHWJ2021b125)。
