Study on the clinical diagnostic value of sFlt-1,D-Lactate and LDH Expression in acute severe pancreatitis complicated with infection
Objective:To investigate the clinical diagnostic value of soluble fms-like tyrosine kinase-1(sFlt-1),D-lactate,and lactate dehydrogenase(LDH)expression in patients with acute severe pancreatitis(SAP)complicated with infection,as well as the bacterial flora distribution and drug resistance.Methods:A ret-rospective analysis was conducted on 80 SAP patients admitted to the emergency department of Xinyang People's Hospital from December 2021 to November 2023.Patients were divided into two groups based on whether SAP was complicated with infection:Group A(SAP only)and Group B(SAP with infection).The clinical diagnostic value of sFlt-1,D-lactate and LDH expression,as well as the bacterial flora distribution and drug resistance,were e-valuated in patients with SAP complicated with infection.Results:(1)There were no significant differences in BMI,HDL-C,LDL-C,FBG,BUN,TC,TG,hs-CRP and D-dimer levels between Groups A and B(P＞0.05).(2)The expression levels of sFlt-1,D-lactate and LDH were significantly lower in Group A compared to Group B(P＜0.05).(3)For individual test,the AUC values of sFlt-1,D-lactate and LDH were 0.876,0.765,and 0.812,respectively.The sensitivity(SEN)was 82.43％,83.05％and 83.45％,and the specificity(SPE)was 79.54％,76.43％,and 80.00％,respectively.When the three markers were used in combination for diagnosis,the the AUC SEN,and SPE reached 0.937,91.44％,and 91.23％,respectively.The isolation rates from blood or central venous catheter,necrotic tissue,abdominal pus,peritoneal drainage,and bile were 17.41％,27.86％,17.91％,24.38％,and 12.44％respectively.(4)A total of 201 bacterial strains were isola-ted from 80 SAP patients with infection,including Staphylococcus 27.86％,Streptococcus 19.40％,Pneumococcus 20.40％,Gonococcus 14.43％,Meningococcus 10.45％,and others 7.46％.The main sources of infection were blood pressure or central venous catheters 17.41％,necrotic tissue 27.86％,abdominal pus 17.91％,peritoneal drainage 24.38％,and bile 12.44％.(5)The overall resistance rates of five antifungal drugs(5-fluorocytosine,amphotericin B,itraconazole,fluconazole,and voriconazole)among the various bacterial strains were 82.59％,90.55％,54.73％,76.62％and 98.51％,respectively.Conclusion:The combined diagnosis of sFlt-1,D-lactate and LDH shows higher value in the early diagnosis of SAP complicated with infection,demonstrating good clinical application potential.Additionally,the bacterial flora distribution and drug resistance patterns vary among SAP patients with infection during clinical treatment.
万方数据
维普
