Evaluation Of Diagnosis And Prediction Of Severity Of Acute Pancreatitis In Pregnancy By NLR,PLR,RPR

Aim Acute pancreatitis in pregnancy(APIP)is a rare condition,however,it significantly threatens the maternal and fetal health.The aim of this study is to investigate the types,clinical characteristics and severity of APIP.Moreover,neutrophil to lymphocyte ratio(NLR),platelet to lymphocyte ratio(PLR)and RDW platelet ratio(RPR)were tested to confirm their diagnostic and prognostic significance in APIP.Methods Twenty-six APIP cases in the First and Second Affiliated Hospital of Guangxi Medical University from December 2005 to June 2018 were reviewed retrospectively.AP diagnosis was based on 2012 Atlanta Criteria.One hundred non-pregnant women with acute pancreatitis and 101 healthy pregnant women were randomly selected as the control group.By comparing and analyzing the differences of NLR,PLR and RPR among three groups and APIP patients with different severity,the value of these three indices in APIP diagnosis and prediction of severity was evaluated.Results The common causes for APIP were gallstone(46.2%)and hypertriglyceridemia(30.8%).NLR,PLR and RPR was significantly elevated in the APIP group when compared with the healthy pregnant women group(P<0.001).ROC curve analysis results for NLR showed that there was a significant prediction power of NLR(R~2=0.979;P<0.001)in APIP.For NLR parameter,if the cut-off value is chosen to be 5.1335,the sensitivity is 96.2%and the specificity is 92.0%.Among patients with APIP,there were statistically significant differences in RPR among mild,moderate and severe patients,and its value in predicting disease severity was superior to that of High-sensitivity C-reactive protein(HS-CRP).Conclusions Serum NLR may be valuable in diagnosing APIP in pregnant patients with acute abdomen.RPR can be used to predict the severity of disease in APIP patients at an early stage.The higher RPR is,the worse the disease will be.