The Relationship Between Uric Acid And The Severity Of Acute Pancreatitis

Objective: Based on uric acid may play a critical role in promoting the development of acute severe pancreatitis,the relationship between UA level and organ failure OF patients with acute pancreatitis in our hospital was analyzed.Explore the predictive ability of uric acid as inflammatory marker of organ failure in acute pancreatitis,and other conventional clinical indicators such as hematocrit(Hct),urea nitrogen(BUN),creatinine(Scr),the predictive ablity of the and pancreatitis CT score and BASIP score were compared.Methods: A retrospective review of 196 patients with acute pancreatitis from September 2015 to September 2018 in Yan'an University Affiliated Hospital was divided into severe and non-severe groups.All patients were analyzed.The uric acid levels were compared between the two groups at 24 h,48h,and 72 h after admission.BUN,Scr,Hct,BASIP score and Balthazar-CTSI score were collected within 24 hours after admission,and the receiver operating characteristic curve(ROC curve)was adopted.The area under the line was evaluated separately to compare the predictive ablity of the presence of OF in pancreatitis.Different statistical analysis were performed using SPSS20.0 software.The evaluation of the ability of different indicators to predict the severity of acute pancreatitis was performed by using the Prism software to plot the area under the ROC curve and the Z-test to compare and analyze the critical value,sensitivity,specificity and other evaluation indicators.Correlation analysis was performed using no OR ordered multiclassification Logistic regression,and OR value was calculated,and forest map was drawn using GrapPad Prism 6.4 software.Results:1.There were statistical differences in 24 hUA,BUN,Scr,BISAP scores,and althazar-CTSI scores between the severe and non-severe patients with acute pancreatitis(t values were-4.355,-1.921,-4.227,-4.621,-6.849,-11.477,P value <0.05);,the average value of Hct,48 hUA,72hUA between the two groups was higher than the lower limit of normal value,and there was no statistically significant difference(P>0.05).2.With the increase of hospitalization time(24h,48 h,72h)of the 196 patients enrolled,the overall mean UA value decreased,especially in the severe group,and the UA values in each group were statistically different in different time periods(x2=28.1,p<0.05).The UA predicted critical values in 24 h,48h,72 h were 304 mol/l,234 mol/l,165 mol/l,and 24 hUA value had good sensitivity and specificity for the prediction OF OF,followed by 72 hUA at 48 h.When adjusted for 48 h and 72 hUA level changed,the incidence OF was 5.4 times when UA value was 304 mol/l.3.There were respectively statistical significance(P<0.05)in the 24 hUA,BUN,Scr,Balthazar-CTSI scores,BISAP scores which were compared to predict the OF ability and the area under the ROC curve were 0.720,0.710,0.678,0.890,and 0.680.The predictive ability of 24 hUA was basically equivalent to BUN,and slightly better than BUN.However,the latter had poor sensitivity and relatively high specificity.Although Scr was lower than 24 hUA and BUN,it had better specificity.The critical values of BUN,Scr and CTSI score were respectively 27.4(mg/dl),99(umol/l)and 4 points.CTSI scores have better sensitivity,specificity and predictive power than BISAP scores in clinical score comparison.4.Scr;BUN;Balthazar-CTSI score;BISAP score;24 h UA value included in the disordered multivariate logistic regression model,the model was statistically significant(P <0.01).The regression coefficient suggested that the included indicators were statistically significant(P <0.05).24 hUA,BUN,Balthazar-CTSI score,BISAP score are independent risk factors in the occurrence of MOF.The incidence of MOF increased by one unit was respectively as high as 5.89,5.41,15.48 and 5.40 times.Conclusion:1.The UA level of the enrolled patients increased,and the mean of the severe group was higher than that of the light group.With the treatment,the UA level in the severe group decreased rapidly,and the light group decreased slowly.The 24 h UA value had a good predictive ability of OF and a certain stability of Sensitivity and specificity,and its predictive ability is comparable to BUN,superior to Scr.2.The pancreatic gland enhanced computed tomography(CT)or magnetic resonance(NMR)to the hospital inspection has a good visual in the prediction of OF,with better sensitivity and specificity.However,some patients may fail to perform due to radiation damage to body damage and contrast agent allergy,and may be combined with relevant clinical indicators,such as BUN,Scr,Hct,etc,clinical scoring system(BISAP,Ranson,Glasgow,APACHE II,Marshall score,etc.)which can develop some better options for clinical treatment.3.AP as a systemic system of inflammatory diseases,its pathogenesis is unknown and inflammation activation pathway is complex,and a single MI index can not fully and accurately assess its AP condition.The detailed role of UA in the development of AP should be clarified by basic studies,and its clinical predictive ability should be further confirmed by multi-center prospective cohort studies.