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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

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

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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.
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)