| Objective:1.To explore the correlation and degree between bedside index for severity in acute pancreatitis score(BISAP),procalcitonin(PCT)and red blood cell distribution width(RDW)about severity and prognosis of acute pancreatitis.2.To analyse the value of BISAP score combined with PCT and RDW in predicting different conditions and outcomes of acute pancreatitis,and respectively to compare with the three,in order to explore whether adding PCT and RDW into BISAP score could improve the sensitivity and specificity of early prediction.Methods: To retrospectively analyse 70 patients with acute pancreatitis(AP)admitted to the first affiliated hospital of hebei north university from September 2017 to September 2019.According to the 《2012 revision of the acute pancreatitis in Atlanta classification guide》,disease severity can be divided into mild acute pancreatitis group(MAP),for 40 cases,and moderately severe acute pancreatitis was classified as severe acute pancreatitis group(MSAP + SAP),for 30 cases;Then,the severe group was divided into two subgroups according to the different outcome of the disease,namely,the rehabilitation group(20 cases)and the death group(10 cases).To record serum procalcitonin(PCT),RDW values and other relevant indicators(blood BUN,consciousness disorder,systemic inflammatory response(SIRS),age,pleural effusion,1 point each,5 points in total)within 24 hours of onset and obtain.BISAP scores.By using statistical methods,to analyse and evaluate the correlation and predictive value between these three indicators about the disease.Results: 1.The study finds that the BISAP score,PCT and RDW in MSAP+SAP group were significantly higher than those in MAP group interms of disease severity(P<0.05);In different prognosis,the BISAP score,PCT and RDW in the death group were significantly higher than those in the recovery group(P<0.05).2.Binary Logistic regression analysis: Through regression analysis,it can be calculated that the three indicators have a high correlation degree with disease(P < 0.05),which can be used to predict AP in the early stage.However the OR value of the BISAP score was larger than that of the other two measures,both in terms of disease severity and mortality,so the correlation was stronger.3.ROC curve analysis: In different degrees of AP,although the AUC and sensitivity of PCT were the highest,the specificity was not as good as RDW.In different AP prognosis,although the AUC of RDW was higher than the other two indicators,the sensitivity had no significant advantage compared with BISAP score,and the specificity was lower than PCT.According to the statistical data,any single indicator did not show an obvious and absolute advantage in predicting the severity and mortality of AP.Therefore,in order to find the absolute advantage,the critical value obtained by ROC curve was obtained : 1.31ng/ml≤PCT < 3.085ng/ml and 14.79%≤RDW <15.28% were recorded as one score respectively;PCT≥3.085ng/ml and RDW≥15.28% were recorded as 2 points respectively added into the BISAP score.The scores of AP patients were recalculated.Results: the AUC,sensitivity and specificity of severe pancreatitis and death predicted were 0.925,90%,80% and 0.903,90% and 90%,respectively,from BISAP score combined with PCT and RDW.The predictive value was significantly higher than that of the original BISAP score,and the AUC and sensitivity of the combined scoring system were also higher than that of PCT and RDW.However,the specificity in assessing the degree of illness was slightly less than that of RDW(85%),which may be influenced by the sample size.Conclusion: 1.The BISAP score,PCT and RDW all showed an increasing trend in different conditions and development of acute pancreatitis,and were significantly correlated with the severity of the disease.2.The BISAP score,PCT and RDW can all be used to assess the severity and prognosis of AP patients effectively,but the combined test is better than the independent test,which can further improve the accuracy of prediction.It is worthy of promotion. |
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