Correlation Analysis Of AP Gastrointestinal Dysfunction And CRP,PCT,APACHE?,MCTSI Score

Objective To use the modified gastrointestinal failure(iGTF)score as a mean to evaluate acute pancreatitis(AP)gastrointestinal dysfunction.To investigate the relationship between the inflammatory markers serum such as C-reactive protein(CRP),procalcitonin(PCT),acute physiology and chronic health evaluation ?(APACHEII)score and modified computed tomography severity index(MCTSI)score and the hospitalization days and gastrointestinal dysfunction in early acute pancreatitis.Methods Retrospectively collecting the clinical data of 69 patients with AP who were admitted to the emergency medical department and intensive care unit(ICU)from February 2014 to October 2016.Serum C-reactive protein(CRP),procalcitonin(PCT)levmodified els within 24 hours since admission,length of hospital stay,and gastrointestinal failure(iGIF)score,APACHEII score,MCTSI score within 24 hours since admission.All cases were divided into two groups according to iGIF score:mild gastrointestinal dysfunction(iGIF-4)and severe gastrointestinal dysfunction(iGIF>4).serum CRP,PCT levels,APACHEII scores,MCTSI scores,the days of hospitalization were compared between the two groups.iGIF scores and serum CRP,PCT levels,APACHEII scores,and MCTSI scores were used to perform ROC curve analysis.Results(1)General condition of patients:according to the iGIF score,of the 69 patients with AP,32 patients(46.4%)had mild gastrointestinal dysfunction,37 patients(53.6)had severe gastrointestinal dysfunction,and 46 men(66.7%),23 women(33.3%);age 43.49±14.54 years old.(2)Comparing with the laboratory parameters,clinical scores system,hospitalization days between two groups:there were significant differences in serum CRP levels,APACHE ? scores,MCTSI scores,and days of hospitalization between the two groups(P<0.05).There was no significant difference in serum PCT levels between(P>0.05).(3)The ROC curve distribution of laboratory indicators and clinical scores system:The AUC of serum CRP was 0.741(P=0.001,confidence interval 0.624-0.859),and the critical value was 199.5 mg/L(sensitivity 0.622,specificity 0.812).The AUC of serum PCT was 0.683(P=0.009,confidence interval 0.554-0.812),and the cut-off value was 1.24 ng/ml(sensitivity 0.541,specificity 0.812).APACHE II score had an AUC of 0.749(P=0.000,confidence interval 0.632-0.867)and a cutoff value of 8.5(sensitivity 0.865,specificity 0.594).The AUC for the MCTSI score was 0.93(P=0.000,confidence interval 0.868-0.986),and the cutoff value was 7(sensitivity 0.811,specificity 0.906).Conclusion(1)The early stages of acute pancreatitis cause varying degrees of gastrointestinal dysfunction.(2)There is a statistical significance for early assessment of gastrointestinal dysfunction in AP of Serum CRP.There is no statistical significance in Serum PCT for the early assessment of gastrointestinal dysfunction in AP.(3)The MCTSI and APACHE ? scores are valuable for the early assessment of gastrointestinal dysfunction in patients.There is a higher evaluation value in the MCTSI score.