摘要
目的探讨急性胰腺炎(AP)患者入院第一周血压联合降钙素原(PCT)、脂肪酶(LPS)检测对后期感染性胰腺坏死的预测价值,并分析后期感染性胰腺坏死的影响因素。方法回顾性分析2011年1月-2016年1月医院收治的300例AP患者的临床资料,依据患者后期是否发生感染性胰腺坏死,分为感染组101例和非感染组199例。两组均采用AP常规治疗方案,分析患者的基本情况(包括性别、年龄、病因、合并症等)、入院时临床检查指标[包括白细胞计数(WBC)、血红蛋白(HB)、血浆白蛋白(ALB)、血淀粉酶(AMS)、血脂肪酶(LPS)、降钙素原(PCT)和C-反应蛋白(CRP)]、急性生理学与慢性健康状况评分II(APACHE II)及入院第一周低血压的发生率等,归纳后期感染性胰腺坏死的影响因素,并采用ROC曲线分析第一周低血压联合LPS、PCT检测对后期感染性胰腺坏死的预测价值。结果两组患者入院后的LPS、PCT、第一周低血压发生率及APACHE II,差异均有统计学意义(P<0.05)。LPS、PCT、第一周发生低血压及APACHE II是AP患者后期发生感染性胰腺坏死的影响因素(P<0.05)。ROC曲线分析结果显示,第一周低血压+LPS+PCT检测的灵敏度、特异度分别为0.902、0.860高于第一周低血压+PCT检测、第一周低血压+LPS检测及LPS、PCT单项检测。结论第一周低血压、PCT、LPS可作为预测AP患者发生后期感染性胰腺坏死的重要指标,三者联合检测可提高预测的敏感度和特异度,同时第一周低血压、LPS、PCT及APACHE II评分也是发生后期感染性胰腺坏死的影响因素。
OBJECTIVE To investigate the predictive value of blood pressure combined with procalcitonin(PCT)and lipase(LPS)in late infectious pancreatic necrosis in patients with acute pancreatitis(AP)at the first week after admission,and to analyze the influencing factors of late infectious pancreatic necrosis.METHODS The clinical data of 300 patients with AP who were treated in our hospital from Jan.2011 to Jan.2016 were retrospectively analyzed.According to the occurrence of infected pancreatic necrosis at the late stage,they were divided into infected group(101 cases)and noninfected group(199 cases).The two groups were both treated with AP routine treatment.The basic situation of patients in two groups(including gender,age,etiology,complications),clinical examination indexes at admission [including white blood cell count(WBC),hemoglobin(HB),plasma albumin(ALB),serum blood amylase(AMS),serum lipase(LPS),procalcitonin(PCT)and C reactive protein(CRP)],acute physiology and chronic health evaluation II score(APACHE II)and the incidence of hypotension at the first week after admission were compared.The influencing factors of late infectious pancreatic necrosis were analyzed by logistic regression analysis,and the ROC curve was used to analyze the predictive value of hypotension at the first week combined with LPS and PCT for the late-stage infectious pancreatic necrosis.RESULTS The levels of LPS,PCT,the incidence of hypotension at the first week and the APACHE II score in the two groups after admission were significant(P<0.05).Hypotension,LPS,PCT and APACHE II scores in the first week were the influencing factors of late-stage infectious pancreatic necrosis in AP patients(P<0.05).ROC curve analysis showed that the sensitivity and specificity of the first week hypotension+LPS+PCT test were 0.902 and 0.860 respectively,which were higher than those of the first week hypotension+PCT test,the first week hypotension+LPS test and the single test of LPS and PCT.CONCLUSION Hypotension at the first week,PCT and LPS levels can be used as
作者
杨丽
王志强
袁伟华
吴畅
YANG Li;WANG Zhi-qiang;YUAN Wei-hua;WU Chang(The Central Hospital of Wuhan Affiliated to Tongji Medical College Huazhong University of Science and Technology,Wuhan,Hubei 430000,China;不详)
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2019年第3期410-414,共5页
Chinese Journal of Nosocomiology
基金
湖北省卫计委科研基金资助项目(WJ2015Mk058)
关键词
急性胰腺炎
感染性胰腺坏死
降钙素原
脂肪酶
血压
预测价值
影响因素
Acute pancreatitis
Infectious pancreatic necrosis
Procalcitonin
Lipase
Blood pressure
Predictive value
Influencing factor
