The Diagnostic Value Of Inflammatory Markers And D Dimer Level In Secondary Infection Of Acute Pancreatitis

Objective To investigate the predictive value of procalcitonin?C-reactive protein?leukocyte count and D dimer in the assessment of secondary infection in patients with pancreatitis.Methods Retrospective study of 123 patients with acute pancreatitis who was treated by Anhui Medical University First Affiliated Hospital from June 2015 to June 2018,including 70 males and 53 females.The patients were divided into infection group(53 cases)and uninfected group(70 cases)according to whether there were secondary infections in one month of admission.The infected group was divided into local infection group(37cases)and general infection group(16 cases)according to whether there were local abdominal infection or sepsis.To compare the predictive value of PCT,CRP,WBC and D-dimer for secondary infection and severity of infection.Results1.Significant difference of procalcitonin?C-reactive protein and D-dimer were founded between the infected and uninfected groups with[2.43(1.21-6.21)]ng/m L vs [0.32(0.10-0.93)] ng/m L,(158.03±132.62)mg/m L vs(79.26±80.10)mg/m L and(7.28±4.56)?g/L vs(2.07±1.86)?g/L(P<0.05).The difference of leukocyte count between the two groups was not significant with(14.59±4.99)×10~9/L vs(12.73±5.42)×10~9/L(P=0.053)respectively.2.The significant difference of procalcitonin between local and general infection group with(3.04±3.36)ng/m L vs(15.02±14.83)ng/m L(P<0.05),The difference of C-reactive protein,D-dimer and leukocyte count between the two groups was not significant with(156.83±142.94)mg/m L vs(160.80±109.17)mg/m L,(7.20±4.00)?g/L vs(7.46±5.81)?g/L,and(14.39±4.67)×10~9/L vs(15.07±5.79)×10~9/L(P>0.05),3.The predictive value of D-dimer level is better than procalcitonin and C-reactive protein level.The area under the ROC was 0.917 with sensitivity 90.6% and specificity78.6%.But the PCT level can predict the severity of secondary infection in later stage.Conclusions Procalcitonin,C-reactive protein and D-dimer level in blood can be used as diagnosis index to predict secondary infection in patients with acute pancreatitis,and D-dimer was better than procalcitonin and C-reactive protein after admission.But the procalcitonin level can predict the severity of secondary infection in later stage.