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基于血常规的炎症评分系统对复杂性胰腺炎的预测价值

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目的 探讨基于血常规的炎症评分系统对复杂性胰腺炎(CAP)的预测价值。方法 回顾性分析2021年1月至2024年1月在重庆两江新区人民医院接受治疗的630例急性胰腺炎患者的临床资料,按照疾病严重程度将其分为轻症急性胰腺炎(MAP)组(n=420)和CAP组(n=210)。采用倾向评分匹配平衡两组病例基线特征,分析入院24 h内基于血常规的炎症评分系统[中性粒细胞淋巴细胞比率(NLR)、衍生粒细胞淋巴细胞比率(dNLR)、淋巴细胞单核细胞比率(LMR)、血小板淋巴细胞比率(PLR)、全身免疫炎症指数(SII)、全身炎症反应指数(SIRI)]和临床结局指标间的差异,采用logistic回归分析CAP的危险因素。结果 通过倾向性评分匹配,共有404例患者纳入研究,两组各202例。35例(16。7%)接受过重症监护室(ICU)治疗和4例(1。9%)死亡患者均出现在CAP组中。与MAP组比较,CAP组 WBC、中性粒细胞、C反应蛋白(CRP)、尿素氮、淀粉酶、脂肪酶水平及NLR、dNLR、SII、SIRI评分更高,血清钙和白蛋白水平更低,差异有统计学意义(P<0。05)。逐步logistics回归分析提示,CRP、白蛋白、脂肪酶、血清钙、SIRI是CAP发生独立影响因素(P<0。05)。结论 基于血常规的炎症评分系统可预测CAP的发生。
Predictive value of inflammation scoring system based on blood routine for complicated acute pancreatitis
Objective To investigate the predictive value of the inflammation scoring system based on the blood routine for complicated acute pancreatitis(CAP).Methods The clinical data of 630 patients with a-cute pancreatitis(AP)receiving the treatment in the People's Hospital of Chongqing Liang Jiang New Area from January 2021 to January 2024 were retrospectively analyzed.The patients were divided into the mild a-cute pancreatitis(MAP)group and CAP group according to the disease severity degree.The propensity score matching was used to balance the baseline characteristics of the cases in the two groups,the differences be-tween the inflammatory scoring system based on the blood routine[neutrophile granulocyte/lymphocyte ratio(NLR),derived neutrophile granulocyte/lymphocyte ratio(dNLR),platelet/lymphocyte ratio(PLR),system-ic immune inflammatory index(SII)and systemic inflammatory response index(SIRI)]and the clinical out-come indexes within 24 h of admission were analyzed,and the logistic regression was used to analyze the risk factors of CAP.Results A total of 404 patients were included in the study by the propensity score matching,each 202 cases in the two groups.In the CAP group,there were 35 cases(16.7%)receiving intensive care unit(ICU)treatment and 4 cases(1.9%)of death.Compared with the MAP group,WBC,neutrophile granulo-cyte,CRP,BUN,amylase and lipase levels and NLR,dNLR,SII and SIRI scores in the CAP group were high-er,serum calcium and albumin levels were lower,and the differences were statistically significant(P<0.05).The stepwise logistics regression analysis showed that CRP,albumin,lipase,serum calcium and SIRI were the independent influencing factors of CAP occurrence(P<0.05).Conclusion The inflammation scoring system based on the blood routine could predict the CAP occurrence.

acute pancreatitiscomplicated pancreatitisblood routineinflammatory indexsystemic immune inflammatory index

黄晓利、唐永梁、许佳、杨俊涛、刘孟刚

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重庆两江新区人民医院肝胆胰外科,重庆 401121

陆军军医大学大坪医院肝胆外科,重庆 400042

急性胰腺炎 复杂性胰腺炎 血常规 炎症指数 全身炎症反应指数

2024

重庆医学
重庆市卫生信息中心,重庆市医学会

重庆医学

CSTPCD
影响因子:1.797
ISSN:1671-8348
年,卷(期):2024.53(22)