| Objective:To evaluate the value of combining lactate dehydrogenase(LDH),blood urea nitrogen(BUN)and albumin(ALB)for the early prediction of acute pancreatitis severity.Methods:Data of acute pancreatitis(AP)patients wereretrospectively analyzed inthe First Affiliated Hospital of Gannan Medical University from January 2020 to December 2022,including general information and laboratory indicators.Based on the 2012 Atlanta categorization criteria,AP patients were divided into mild acute pancreatitis(MAP)group,moderate severe acute pancreatitis(MSAP)group and severe acute pancreatitis(SAP)group.1.SPSS21.0 software was used to analyze the differences of general data,LDH,BUN,ALB and other indicators among the three groups;2.Spearman correlation analysis was used to explore the correlation between LDH,BUN,ALB and APseverity in three groups.3.Build model 1: MAPgroup and non-MAP group(MSAP group +SAP group)and model 2: SAP group and non-SAP group(MAP group +MSAP group),and multivariate Logistic regression was used to analyze the influencing factors of non-MAPgroup and SAP group in the two models.4.Draw the receiver operating characteristic(ROC)curves in the two models and calculate the area under the curves(AUC)to analyze the predictive value of LDH,BUN and ALB alone and combined on the severity of AP.Results:1.Atotal of 340 APpatients who meet the standard were included,there were 194 patients in the MAP group,82 patients in the MSAP group and 64 patients in the SAP group.2.The analysis of general data among the three groups showed that there wereno statistical differences in gender and etiology among the three groups(P>0.05).There were statistical differences in age between SAP group and MAP group,SAP group and MSAP group(P<0.05),but no statistical differences between MAP group and MSAP group(P>0.05).3.The analysis of laboratory index among the three groups showed that neutrophil,white blood cell,platelet,monocyte,neutrophil-lymphocyte ratio,fibrinogen,D-dimer,procalcitonin,C-reactive protein,serum creatinine,calcium,alanine aminotransferase and aspartate aminotransferase were statistically different among the three groups(P<0.05).There have no statistical difference in lymphocyte,platelet-lymphocyte ratio and red blood cell among the three groups(P>0.05).There were statistically different in D-dimer,procalcitonin and calcium in pairwise comparison among the three groups(P<0.05).4.The analysis of research indicators among the three groups showed that BUN,LDH and ALB were statistically different between the three groups(P<0.05).5.The analysis of spearman correlation analysis showed that BUN and LDH were positively correlated with AP severity,while ALB was negatively correlated with AP severity,and the correlation coefficients respectively were 0.427,0.502 and-0.428.6.In Model 1,the results of multivariate logistic regression analysis showed that BUN and LDH are independent risk factors for non-MAP,and ALB is independent protective factor for non-MAP.According to ROC curve,AUC predicted by BUN,LDH and ALB separately and jointly were0.715(95%CI: 0.658～0.771),0.774(95%CI: 0.722～0.826)and 0.728(95%CI: 0.672～0.783),0.804(95%CI: 0.756～0.852),the sensitivity and specificity were(47.3%,86.6%),(72.6%,77.3%),(53.4%,86.1%),(80.1%,68.6%),respectively.7.In Model 2,the results of multivariate logistic regression analysis showed that BUN and LDH are independent risk factors for SAP,and ALB are independent protective factor for SAP.According to ROC curve,the AUC predicted by BUN,LDH and ALB separately and jointly were 0.816(95%CI: 0.750～0.882),0.805(95%CI: 0.743～0.867)and 0.778(95%CI: 0.710～0.846),0.851(95%CI: 0.793～0.909),the sensitivity and specificity were(68.8%,83.7%),(78.1%,69.2%),(68.8%,79.0%),(68.8%,89.9%),respectively.Conclusion:BUN,LDH and ALB within 24 hours after admission can be used as early predictors of AP severity,and the combined prediction efficiency of the three indexes is better than that of a singleindex. |
PDF Full Text Request