| Objective:To explore the serological indicators of heparin binding protein(HBP),C-reactive protein(CRP),procalcitonin(PCT)combined with acute physiology and chronic health(acute physiology and chronic health)Evaluation Ⅱ,APACHE Ⅱ)The correlation research and clinical significance of the early diagnosis of SAP patients and the evaluation of the disease.Methods:From October 2018 to February 2021,212 patients with acute pancreatitis admitted to the emergency department of the First Affiliated Hospital of Bengbu Medical College were collected.According to the AP diagnostic criteria,they were divided into 88 cases of SAP patients and 124 cases of non-SAP patients.The records of the two groups were recorded.General clinical data(age,gender),detect HBP,CRP,PCT at admission,and perform APACHE Ⅱ scores on them.Spearman correlation analysis and operating characteristic curve(ROC)are used to evaluate HBP,CRP,PCT,APACHE Ⅱ scores and the combination of multiple The clinical value and significance in the early evaluation of severe acute pancreatitis.Results: 1.The general clinical data of the two groups were compared.The average age of the non-SAP group was 56.10±11.87 years;the average age of the SAP group was 56.90±10.87 years,P>0.05.Gender of non-SAP group(male): 60.0%,gender of SAP group(male): 62.5%;there was no statistical significance between the age and gender of the two groups.2.Correlation analysis showed that: Spearman correlation analysis of HBP,CRP,PCT,APACHE Ⅱ scores and the combination of the two or more are positively correlated with severe acute pancreatitis.Among the individual indexes,the highest correlation of APACHEⅡ score was r=0.652,and among the serological indexes,the highest correlation of HBP was r=0.530.When multiple indicators are combined,the combination of four indicators is more correlated than the combination of three or two indicators,and the correlation is r=0.759(P<0.05).3.ROC curve analysis shows that:(1)Compared with individual indicators,the area under the APACHE Ⅱ score curve is the largest(AUC)=0.880,and the sensitivity is also the highest 88.6%;among the serological indicators,the area under the HBP curve(AUC)is the largest 0.810,while HBP The sensitivity is also the highest at 69.3%,but the specificity(79.0%)is lower than the PCT specificity(86.3%);(2)When the three serological indicators are combined(HBP+CRP+PCT)not only the maximum area under the curve(AUC)is 0.882,but the sensitivity(77.3%)and specificity(88.7%)are better than the single index or double index combination Prediction;this result shows that HBP,CRP,PCT can predict SAP very well(P<0.05),and the combined prediction of the two is greater than that of a single index,and the combined prediction of the three has the highest effect.(3)When the APACHE Ⅱ system score is combined with the three indicators of serology,the area under the curve(AUC)is as high as 0.945,and the most sensitive predicting SAP is 92.0%.The specificity of 85.5% is slightly lower than the combination of the three indicators of serology,but The positive likelihood ratio is6.345 as high,and the negative likelihood ratio is the lowest at 0.094,which has the most clinical significance.Conclusion : 1.The levels of HBP,CRP,PCT and the APACHE Ⅱ score are positively correlated with the early diagnosis of SAP and the prediction of disease severity.Among them,the APACHE Ⅱ score has the highest correlation;in the prediction of serological single factor indicators,The correlation and sensitivity of HBP are the most sensitive,but the specificity of PCT has more clinical value.2.HBP,CRP,PCT combined with APACHE Ⅱ score in the early diagnosis of SAP and the prediction of the severity of the disease are more accurate and clinically meaningful than the three,the combination of the two or a single index.This study shows that the HBP,CRP,PCT combined with APACHE Ⅱ scores have high guiding significance and clinical value in the early diagnosis of SAP and the evaluation of disease conditions. |
PDF Full Text Request