The Diagnostic Value Of C-reactive Protein?procalcitonin And Triglyceride In Hyperlipidemic Acute Pancreatitis

Objectives:Toanalyze clinical features of hyperlipidemic acute pancreatitis(HLAP)and non acute hyperlipidemic pancreatitis(NHLAP),and evaluate the role of C-reactive protein(CRP),procalcitonin(PCT),triglyceride(TG)in the prediction of severe HLAP and the incidence of pseudocysts.Methods:925 cases of acute pancreatitis(AP)from July 2009 to December 2016 from the Second Affiliated Hospital of Soochow University were included in this retrospective study,with 322 HLAP cases and 603 NHLAP cases.Clinical characteristics of HLAP and NHLAP were recorded and compared with each other.Receiver operating characteristic curve(ROC)analysis was used to assess the serum CRP and PCT concentration to predict severe HLAP and occurrence of pseudocysts.Results:There were statistically significant differences in gender,age,serum amylase,CRP,white blood cell,hemoglobin,greasy diet,comorbidities(diabetes,fatty liver),ARDS,pseudocysts,local complications between HLAP and NHLAP(P<0.05);In the early phase of HLAP,CRP,PCT and TG concentration has a higher accuracy in the diagnosis of severe acute pancreatitis(SAP),in which the severity of AP was based on Balthazar criteria(D and E)or the 2012 revision of the Atlanta classification and definitions by international consensus.The best cut-off values of CRP,PCT and TG in the prediction of pseudocysts occurrence in HLAP with the highest Youden index were 169.9mg/L on the sixth day with sensitivity 80% and specificity 85%,0.84ug/L on the first day with sensitivity 89% and specificity 78%,and 11.45mmol/L on the second day with sensitivity 71%and specificity 80%,respectively.Conclusions:HLAP were characterized with a much higher incidence than ever,and with much more severe clinical presentation and more common complications(peripancreatic effusion,ARDS),when compared with NHLAP patients.CRP,PCT and TG have good accuracies in the prediction of severe acute pancreatitis(SAP)and pseudocysts occurrence,which could be used in the clinic in the future.