重庆医学2024,Vol.53Issue(22) :3441-3446.DOI:10.3969/j.issn.1671-8348.2024.22.014

基于血常规的炎症评分系统对复杂性胰腺炎的预测价值

Predictive value of inflammation scoring system based on blood routine for complicated acute pancreatitis

黄晓利 唐永梁 许佳 杨俊涛 刘孟刚
重庆医学2024,Vol.53Issue(22) :3441-3446.DOI:10.3969/j.issn.1671-8348.2024.22.014

基于血常规的炎症评分系统对复杂性胰腺炎的预测价值

Predictive value of inflammation scoring system based on blood routine for complicated acute pancreatitis

黄晓利 1唐永梁 2许佳 1杨俊涛 1刘孟刚1
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作者信息

  • 1. 重庆两江新区人民医院肝胆胰外科,重庆 401121
  • 2. 陆军军医大学大坪医院肝胆外科,重庆 400042
  • 折叠

摘要

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.

Abstract

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.

关键词

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

Key words

acute pancreatitis/complicated pancreatitis/blood routine/inflammatory index/systemic immune inflammatory index

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出版年

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
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