摘要
目的探讨急性胰腺炎严重程度床边指数(BISAP)评分、单核细胞与淋巴细胞比值(MLR)、中性粒细胞与白蛋白比值(NAR)在急性胰腺炎(acute pancreatitis,AP)病情严重程度和预后中的价值。方法回顾性收集2022年1月至2023年12月在西南医科大学附属医院收治的208例AP患者的临床资料,按疾病严重程度分为轻症组(MAP,n=131例)、和重症组(SAP,n=77例);Spearman相关分析BISAP评分、MLR、NAR与病情严重程度及住院天数的关系,二元Logistic回归分析筛选影响患者预后的危险因素,受试者工作曲线(ROC曲线)分析上述指标在AP患者预后中的临床意义。结果SAP组患者住院天数、BISAP评分、MLR、NAR、WBC、PCT、FPG、TC、Ca+等指标高于MAP组,差异有统计学意义(P<0.05);两组在合并症、病因、吸烟史、饮酒史、胆固醇、甘油三酯、肌酐、肾小球滤过率方面差异无统计学意义(P>0.05);经相关分析,BISAP评分、MLR、NAR与AP患者病情严重程度(r=0.474、0.542、0.519)及住院天数(r=0.401、0.370、0.396)均呈正相关,差异有统计学意义(P<0.05);二元Loginstic回归示BISAP评分、MLR、NAR、FPG均为影响患者预后的危险因素;ROC曲线分析BISAP评分、MLR、NAR对AP患者预后不良均有较好的预测性(AUC=0.766、0.825、0.808),三者联合预测效应(AUC=0.863)大于单一指标。结论BISAP评分、MLR、NAR均能较好评估AP患者病情严重程度及预测预后,三者联合运用具有更强大的预测效应及更好得评估意义。
Objective To investigate the value of acute pancreatitis severity bedside index(BISAP)score,monocyte to lymphocyte ratio(MLR),and neutrophil to albumin ratio(NAR)in the severity and prognosis of acute pancreatitis(AP).Methods The clinical data of 208 patients with acute pancreatitis admitted to the Affiliated Hospital of Southwest Medical University from January 2022 to December 2023 were retrospectively collected and divided into mild(MAP,n=131 cases)and severe(SAP,n=77 cases)groups according to the severity of the disease.Spearman correlation test was used to analyze the relationship between BISAP score,MLR,NAR and severity of disease and hospitalization days,and subject operating curve(ROC curve)analyzes the clinical significance of the above indicators in the prognosis of AP patients.Results The number of hospitalization days,BISAP score,MLR,NAR,WBC,PCT,FPG,TC,and Ca+were greater in the SAP group than in the MAP group,differences were statistically significant(P<0.05);while the differences in Comorbidities,etiology,history of smoking,history of alcohol consumption,TC、TG、Ceea、GFR were not statistically significant(P>0.05).By correlation analysis,the BISAP score,MLR and NAR were positively correlated with the severity of the disease(r=0.474、0.542、0.519)and the number of hospitalization days(r=0.401、0.370、0.396),differences were statistically significant(P<0.05).Binary Loginstic regression showed that BISAP score,MLR,NAR,and FPG were all risk factors affecting patient prognosis.ROC curve analysis of BISAP score,MLR,and NAR were predictive of poor prognosis in AP patients(AUC=0.766、0.825、0.808),the combined predictive effect of the three was greater than that of a single index(AUC=0.863).Conclusion The number of hospitalization days,BISAP score,MLR,NAR,WBC,PCT,FPG,TC,and Ca+were greater in the SAP group than in the MAP group,differences were statistically significant(P<0.05);while the differences in Comorbidities,etiology,history of smoking,history of alcohol consumption,TC、TG、Ceea、GFR wer
作者
舒玉林
王逸美
陈小红
李昌平
SHU Yu-lin;WANG Yi-mei;CHEN Xiao-hong;LI Chang-ping(Department of Gastroenterology,Affiliated Hospital of Southwest Medical University,Luzhou 646000,China;Department of Gastroenterology,Chengdu Office Hospital,People′s Government of Tibet Autonomous Region,Chengdu 610041,China)
出处
《现代消化及介入诊疗》
2024年第2期146-150,共5页
Modern Interventional Diagnosis and Treatment in Gastroenterology
基金
西藏自治区自然科学基金项目(XZ2019ZRG)。
