血液淀粉酶、C反应蛋白、降钙素原及乳酸脱氢酶在急性胰腺炎患者病情评价及预后预测中的价值 [中文引用][英文引用]

【摘要】目的：探讨血液淀粉酶、C反应蛋白、降钙素原及乳酸脱氢酶在急性胰腺炎患者病情评价及预后预测中的应用价值。方法：回顾性收集2017年1月至2022年12月在徐州医科大学附属医院住院治疗的240例急性胰腺炎患者临床资料，根据患者病情分为轻症组、中重症组和重症组，对比临床特征和血清指标，随访跟踪患者预后情况，采用多因素logistic回归分析和受试者工作曲线对多种指标预测急性胰腺炎患者预后价值进行分析。结果：重症急性胰腺炎发病率为13.33%。不同病情程度急性胰腺炎患者在血液白细胞、淀粉酶、C反应蛋白、降钙素原、乳酸脱氢酶方面比较，差异有统计学意义（P＜0.05）。相关性分析结果显示，血液淀粉酶、C反应蛋白、降钙素原及乳酸脱氢酶与急性胰腺炎病情程度呈正相关（P＜0.05）。急性胰腺炎患者死亡率为5.83%，多因素logistic回归方程结果显示，淀粉酶、C反应蛋白、降钙素原、乳酸脱氢酶是影响急性胰腺炎患者预后独立因素（P＜0.05）。年龄、饮酒史、白细胞、血小板、甘油三酯不是影响急性胰腺炎患者预后独立因素（P＞0.05）。ROC曲线对血液淀粉酶、C反应蛋白、降钙素原、乳酸脱氢酶以及四种指标联合预测急性胰腺炎预后价值进行分析，曲线下面积分别为0.829、0.850、0.890、0.724、0.936（P＜0.05）。结论：血液淀粉酶、C反应蛋白、降钙素原及乳酸脱氢酶与急性胰腺炎病情程度呈正相关，四种指标单独及联合检测对急性胰腺炎预后有良好的预测价值。

 [Abstract]  Objective  To explore the application value of blood amylase, C-reactive protein, procalcitonin, and lactate dehydrogenase in the evaluation and prognosis prediction of acute pancreatitis patients. Methods  Clinical data of 240 patients with acute pancreatitis who were hospitalized in Affiliated Hospital of Xuzhou Medical University from January 2017 to December 2022 were retrospectively collected. According to the patient's condition, they were divided into mild group, medium severe group, and severe group. Clinical characteristics and serum indicators were compared, and patients’ prognosis was followed up and tracked. The value of multiple indicators in predicting the prognosis of acute pancreatitis patients was analyzed using multivariate logistic regression analysis and receiver operating characteristic (ROC) curves. Results  The incidence rate of severe acute pancreatitis was 13.33%. The differences in white blood cells, amylase, C-reactive protein, procalcitonin, and lactate dehydrogenase levels among patients with acute pancreatitis of different severity were statistically significant (P<0.05). The correlation analysis results showed that blood amylase, C-reactive protein, procalcitonin, and lactate dehydrogenase were positively correlated with the severity of acute pancreatitis (P<0.05). The mortality rate of acute pancreatitis patients was 5.83%. The results of multivariate logistic regression equation showed that amylase, C-reactive protein, procalcitonin, and lactate dehydrogenase were independent factors affecting the prognosis of acute pancreatitis patients (P<0.05). Age, alcohol consumption history, white blood cells, platelets, and triglycerides were not independent factors affecting the prognosis of patients with acute pancreatitis (P>0.05). The ROC curve was used to analyze the prognostic value of blood amylase, C-reactive protein, procalcitonin, lactate dehydrogenase, and the combination of four indicators in predicting acute pancreatitis. The areas under the curve were 0.829, 0.850, 0.890, 0.724, and 0.936, respectively (P<0.05). Conclusion  Blood amylase, C-reactive protein, procalcitonin, and lactate dehydrogenase are positively correlated with the severity of acute pancreatitis. Blood amylase, C-reactive protein, procalcitonin, lactate dehydrogenase, and their combination have good predictive value for the prognosis of acute pancreatitis.