The Value Of C-reactive Protein,Hematocrit And Albumin In Pridicting The Severity Of Acute Pancreatits

Objective: To compare the clinical value of C-reactive protein(CRP),hematocrit(HCT)and albumin(Albumin,ALB)in predicting the severity of acute pancreatitis(AP).Methods: A retrospective analysis of the 889 patients admitted to the First Affiliated Hospital of Guangxi Medical University from 2002 to 2016 was completed.Aged from 18 to 99 years old,all patients completed CRP,HCT,and ALB in 24-48 hours.According to the guidelines for the diagnosis and treatment of acute pancreatitis in China in 2013,AP patients were divided into three groups: mild,moderately severe,and severe.Three groups of general conditions(age,gender)and CRP,HCT,ALB levels were compared.The ROC curve was plotted to analyze and compare the sensitivity,positive predictive value,specificity,negative predictive value,and AUC value of CRP alone,HCT alone,and ALB,and the combination of the two,the three,which to predict SAP and AP complications and prognosis.At the same time,the levels of CRP,HCT and ALB in AP associated organ failure,complication group and AP group without these symptoms were compared,to judge whether the difference was statistically significant.Results: Severe,moderately severe and severe acute pancreatitis had statistically significant differences in sex(P<0.001),There was no significant difference in age between the three groups(P>0.05).HCT was compared with each other in three groups of patients with different classifications of AP,P was greater than 0.05.Compared with MAP(48.41 mg/L±85.80 mg/L),MSAP(60.03mg/L±55.07 mg/L),CRP levels were in SAP(194.44 mg/L±138.77mg/L)was higher,P<0.05,and the difference was statistically significant.Compared with the three groups of ALB,all P<0.05,the difference was statistically significant.In the SAP group,ALB levels(33.43 g/L±7.32 g/L)were the lowest,followed by MSAPs(36.02 g/L±5.91 g/L)and MAPs(39.22 g/L±6.12 g/L)from low to high.CRP,HCT,and ALB in predicting SAP,CRP combined with ALB to predict the severity of AP patients has the best effect,higher than other groups of sensitivity,specificity,negative predictive value.The sensitivity of CRP to ALB was 80.7%,specificity was 86%,and negative predictive value was 94.44%.The specificity(95.9%),positive predictive value(85.9%),and negative predictive value(89.77%)of CRP were higher than those of the other two items(HCT,ALB).The AUC of HCT was 0.538,the AUC of CRP was 0.876,the AUC ofALB was 0.71,the AUC of HCT combined CRP was 0.876,the AUC of HCT combined ALB was 0.727,the AUC of CRP combined ALB was 0.883,and the combined of the three was 0.883.Compared with CRP,and HCT,ALB had a higher AUC in predicting prognosis(abortion of treatment,death),organ failure,and systemic complications,P<0.05,AUC is 0.743(95% CI: 0.660-0.820),0.790(95% CI: 0.700-0.880),0.704(95% CI: 0.650-0.760),0.649(95% CI:0.600-0.700).The ALB and CRP levels in the patients with organ failure,local complications,and systemic complications were significantly different from those without the above symptoms(P<0.05).There was no statistically significant difference in HCT levels,(P>0.05).Conclusion:(1): CRP combined with ALB can judge the severity of SAP.(2): 24-48 hours CRP,ALB can be used as a predictor of SAP,AP severity.(3): ALB may has certain reliability in predicting the complications of AP.