| Objective: In recent years,with the improvement of living standards and the change of dietary structure in China,the incidence rate of hyperlipidemic acute pancreatitis（HLAP）has been increasing significantly.In some regions of China,HLAP even exceeds that of alcoholic acute pancreatitis and becomes the second leading cause of AP.Different from the self-limitation of non-hyperlipidemic severe acute pancreatitis（HLSAP）,HLSAP has a high mortality.To investigate the early evaluation value of serum levels of lipopolysaccharide-binding protein（LBP）,glycoprotein 2（GP2）and procalcitonin（PCT）for condition of patients with hyperlipidemic severe acute pancreatitis（HLAP）.Timely and accurate judgment of the condition of HLAP is helpful for clinical workers to take more effective and individual clinical intervention measures.Methods: Data of HLAP patients treated by emergency surgery in the Second Affiliated Hospital of Anhui Medical University from October 2019 to October 2021 were retrospectively collected,including age,sex and laboratory indicators such as PCT.At the same time,the serum from HLAP patients within 24 h of admission were also collected.According to the severity of HLAP.The patients were divided into non-severe acute pancreatitis（Non-SAP）group with 173 patients and severe acute pancreatitis（SAP）group with 68 patients.The differences of serum levels of LBP,GP2 and PCT between the two groups were compared,and the correlation between these serum levels and the severity of disease were analyzed by Spearman rank correlation.Risk factors for SAP in HLAP patients were analyzed by multivariate Logistic regression,and the sensitivity and specificity of the above indicators to assess the severity of the HLAP were predicted by receiver operating characteristic curve（ROC）.Results: After analyzing the general data of the Non-SAP group and the SAP group,it could be observed that there were no significant differences in age,gender,body mass index,total cholesterol and white blood cell count between the two groups,but there were significant statistical differences in systolic blood pressure,diastolic blood pressure,triglyceride,blood glucose,interleukin-1 and amylase levels.The levels of LBP,GP2 and PCT in SAP group [11.75（6.75-17.75）ng/m L,6.25（4.9-7.1）ng/m L,11.08（6.97-15.12）ng/m L,respectively] were higher than those of Non-SAP group[（0.96±0.34）,（0.48±0.24）ng/m L,and（120.28±61.69）ng/m L,respectively,all P<0.05],and the differences were statistically significant.Spearman rank correlation analysis showed that LBP,GP2 and PCT levels were positively correlated with the Ranson scores at admission（P<0.05）.Multivariate Logistic regression analysis suggested that LBP,GP2,PCT,blood glucose and interleukin-1 were independent risk factors for SAP（P<0.05）.ROC showed that Area under the receiver operating characteristic curve（AUROC）of LBP,GP2 and PCT and the combined detection were0.704（95%CI:0.617-0.791）,0.839（95%CI:0.777-0.901）,0.783（95%CI:0.702-0.864）,0.911（95%CI: 0.861-0.962）,respectively.It follows that the combined detection of LBP,GP2 and PCT indicators has a significantly higher prediction efficiency for HLSAP than the single use of LBP,GP2 and PCT indicators.Conclusion: The serum levels within 24 hours after admission of LBP,GP2 and PCT were significantly correlated with the severity of HLAP.LBP,GP2 and PCT have certain clinical significance for early prediction of the severity of HLAP,and the combination of the three indicators has a higher predictive value. |
PDF Full Text Request