Evaluation Of The Severity Of Acute Pancreatitis By The Ratio Of Proalbumin To Fibrinogen Combined With C-reactive Protein And Proalbumin

Objective: Acute pancreatitis(Acute pancreatitis,AP)is an inflammatory disease.Serious illness can cause Systemic inflammatory response(Systemic inflammatory response syndrome(SIRS)and multiple organ failure even(Persistent outraged failure,POF)or death.There are a variety of clinical indicators used to evaluate the severity of acute pancreatitis,but there is no clear indicator for the rapid and accurate judgment of the severity of early acute pancreatitis.This study was to explore prealbumin and fibrinogen ratio(prealbumin-to-fibrinogen thewire),c-reactive protein(C-reactive protein,CRP)and prealbumin(prealbumin)joint assessment of Acute Pancreatitis,Acute Pancreatitis,AP)the clinical value of illness severity.Methods: a retrospective study was conducted to include patients with acute pancreatitis who were admitted to the department of gastroenterology of the second hospital of hebei medical university from January 2018 to January 2019,aged between 18 and 80 years old.All patients were admitted to the hospital within 24 hours to improve the ratio of c-reactive protein,proalbumin and proalbumin to fibrinogen.According to the 2013 guidelines for the diagnosis and treatment of acute pancreatitis in China,AP patients were divided into two groups: mild and severe.Biochemical,blood routine and inflammatory factors were measured within 24 hours.The levels of c-reactive protein,prealbumin and the ratio of prealbumin to fibrinogen in patients with acute pancreatitis within 24 hours after admission were compared,and the data were analyzed using SPSS21.Pearson correlation analysis was used to analyze the correlation between each indicator and the severity,and ROC curve was drawn to determine the diagnostic efficacy of the individual detection and the combined detection for the severity of acute pancreatitis.To investigate the significance of CRP,albumin,proalbumin,fibrinogen and the ratio of proalbumin to fibrinogen in the determination of acute pancreatitis(AP)severity by single and combined detection.Will according to the illness severity was divided into 345 cases of acute pancreatitis light,181 cases of acute pancreatitis(MAP)group,the light,164 cases of acute pancreatitis(MAP)group,test group of CRP,albumin,prealbumin and fibrinogen ratio,fibrinogen,prealbumin,lactate dehydrogenase,creatinine and urea nitrogen levels,the results showed the MAP group of CRP,fibrinogen and lactate dehydrogenase levels higher than the group MAP,the MAP of albumin,prealbumin and prealbumin and fibrinogen ratio below the MAP group(P < 0.05);Among them,the ratio of areafront albumin to fibrinogen under ROC curve was the highest.By analyzing the ROC curves of individual and combined indicators,it was found that the area under the curve(AUC)detected by CRP,albumin,prealbumin,fibrinogen and the ratio of prealbumin to fibrinogen was higher than that of individual indicators,which could better assess the severity of the disease of AP patients.Results: The WBC count,lactate dehydrogenase,c-reactive protein and fibrinogen in the SAP group were significantly higher than those in the MAP group(P<0.05).The platelet count,proalbumin,albumin,serum calcium and proalbumin/fibrinogen in the SAP group were lower than those in the MAP group(P<0.05).White blood cell count,lactate dehydrogenase,c-reactive protein,and fibrinogen were positively correlated with AP severity,while platelet count,proalbumin,albumin,serum calcium,proalbumin/fibrinogen were negatively correlated with AP severity.The ROC curve of each indicator was drawn,and the area under the former albumin curve was calculated to be(0.781),with a sensitivity of 64.1%,a specificity of 84%,and a Jordan index of 48.1%.The area under the albumin curve was(0.721),with a sensitivity of 72.5%,a specificity of 62.1%,and a Jordan index of 34.6%.The area under the c-reactive protein curve was(0.747),with a sensitivity of 60.1%,a specificity of 81.3%,and a Jordan index of 41.4%.The area under the fibrinogen curve was(0.691),with a sensitivity of 62.8%,a specificity of 70.4%,and a Jordan index of 33.2%.The area under the proalbumin/fibrinogen curve was(0.783),with a sensitivity of 72%,a specificity of 76.1%,and a Jordan index of 48.1%.The area under the serum calcium curve was(0.699),with a sensitivity of 71.7%,a specificity of 67.3%,and a Jordan index of 39%.The area under the LDH curve was(0.729),with a sensitivity of 68.7%,a specificity of 63.2%,and a Jordan index of 48.1%.The area under the curve was 0.817(95%ci: 0.772-0.862),the sensitivity was 86.5%,the specificity was 66.3%,and the yoden index was 52.8.It is suggested that combined detection can improve the diagnostic value of AP severity.Compared with single detection,both of them are improved.Conclusion: the ratio of serum proalbumin to fibrinogen,CRP and proalbumin are of high diagnostic value in determining the severity of acute pancreatitis,and the ratio of serum proalbumin to fibrinogen is the highest under ROC curve.Combined detection can improve the diagnostic efficiency of the severity of acute pancreatitis,suggesting that combined detection has certain guiding significance for the early clinical evaluation of the severity of acute pancreatitis.