The Predictive Value Of RDW,PDW And LDH In Severe Acute Pancreatitis

Objective:1.To explore the correlation between RDW,PDW and LDH and the severity of severe acute pancreatitis.2.The predictive value of RDW,PDW and LDH in severe acute pancreatitis;3.To determine the cut-off value,sensitivity and specificity of RDW,PDW and LDH in the prediction of severe acute pancreatitis,and to evaluate the predictive value of RDW,PDW and LDH in severe acute pancreatitis,so as to provide reference value for clinical diagnosis and treatment of severe acute pancreatitis and reduce the incidence of complications and mortality.Method:A retrospective collection of 537 patients with acute pancreatitis(AP)who were hospitalized at yan 'an university hospital on January 1,2011,solstice and met the diagnostic criteria(gold standard)of Chinese guidelines for diagnosis and treatment of acute pancreatitis(Shanghai,2013)on December 31,2018 was conducted by using the case history browser.The enrolled subjects were divided into two groups according to the severity of AP,the non-severe AP(MAP)group(409 cases)and the severe AP(SAP)group(128 cases).In patients admitted to hospital within 48 hours for testing the patient's red blood cell distribution width(RDW)and platelet distribution width(PDW),lactate dehydrogenase(LDH)and other three indicators,and collect the general clinical data of 537 patients,comparing the difference between the above parameters between two groups of patients,RDW,PDW,LDH and severe acute pancreatitis are analyzed,the relationship between RDW,PDW,LDH three indicators and the correlation between degree of condition in severe acute pancreatitis and separate and joint detection of three index value for the forecast of severe acute pancreatitis.All statistical analyses of the data involved in this study were performed using the SPSS22.0 software package.The measurement data were expressed as mean ± standard deviation((?)± s),and the independent sample t test was used for comparison between the two groups.Chi-2 test was used to evaluate the side effects.The ROC curve was drawn,and the youden index = sensitivity + specificity-1.When the youden index was the largest,the critical value was the most significant.Make binary Logistic regression model according to the boundary value.P<0.05 was statistically significant at the alpha = 0.05 test level.Result:1.The levels of RDW,PDW and LDH in the MAP group and the SAP group were significantly higher than those in the MAP group,with statistically significant differences(P<0.05).2.ROC curves of RDW,PDW and LDH for predicting severe acute pancreatitis were drawn as follows: the area under the RDW curve was 0.682,and the sensitivity,specificity,95%ci and optimal threshold values for predicting SAP disease course were 64.4%,61.4%,0.63-0.734 and 14.05 fl,respectively.The area under the PDW curve was 0.627,and the sensitivity,specificity,95%ci and optimal threshold values for predicting SAP severity were 50.8%,73.6%,0.5677-0.687 and 15.6fl,respectively.The area under the LDH curve was 0.762,and the sensitivity,specificity,95%ci and optimal threshold values of predicting SAP disease degree were 67.4%,81.9%,0.708-0.816 and 285.5u /L,respectively.The area under the curve detected by RDW,PDW and LDH was RDW+PDW: 0.705.RDW + LDH: 0.890;PDW + LDH: 0.821;RDW + PDW,LDH,0.889;The sensitivity and specificity of the three indexes to detect and diagnose the disease degree of SAP by parallel experiment were: RDW+PDW: 60.2%,86.1%,respectively.RDW+LDH: 84.1%,94.1%;PDW+LDH: 72.7%,83.9%;RDW,PDW and LDH: 84.1%,94.4%.3.According to the cut-off value calculated by ROC curve,the values of RDW,PDW and LDH were converted into binary forms.The results of binary Logistic regression model for predicting severe acute pancreatitis showed that RDW,PDW and DH were independent factors for predicting SAP(P<0.05),and the concentrations of xRDW,PDW and LDH were closely related to SAP.Conclusion:1.Compared with MAP group,RDW,PDW and LDH in SAP group were significantly increased,indicating that these three indicators could reflect the severity of SAP disease to some extent.2.The expression levels of RDW,PDW and LDH can be used as predictive indicators of SAP.3.The sensitivity,specificity and accuracy of the combined detection of RDW,PDW and LDH are all higher than that of the single indicator,indicating that the combined detection of RDW,PDW and LDH has a higher predictive value for SAP.4.The critical value of RDW,PDW and LDH in predicting SAP was preliminarily determined,which can be used as the reference value of SAP clinical prediction.