Clinical Analysis Of Changes In Coagulation Function Of Acute Pancreatitis

Objective: Acute pancreatitis is a common critical digestive system diseases,incidence increased year by year.Thrombin time(PT),Activated partial thromboplastin time(APTT),Fibrinogen(Fib),and d-dimer(d-d)are the indicators of thromboplastin function.The changes in coagulation function in acute pancreatitis are still controversial.The purpose of this paper is to explore the changes of coagulation function in acute pancreatitis,the effects on the occurrence and development of the disease,and to clarify the diagnostic value of coagulation indicators.Research object and methods:In this study,retrospective study method was adopted to include the clinical data of 438 patients with acute pancreatitis who first visited the second hospital of hebei medical science university from June 2017 to June 2019.All patients completed the laboratory examination of coagulation indexes and other related laboratory indexes within 24 hours upon admission.According to AP classification criteria,AP patients were divided into MAP group(341 cases)and MSAP+SAP group(97 cases).All AP patients were divided into TMOF group(80 cases),PMOF group(17 cases)and non-PMOFgroup(341 cases)SIRS group(192 cases)and non SIRS group(246 cases)and sepsis group(28 cases),non-sepsis(410 cases),according to the diagnostic criteria of China guidelines for diagnosis and treatment of acute pancreatitis(shenyang,2019).Compare the differences of each group of coagulant function index volatility,other related laboratory indexes is analyzed with Pearson correlation with AP coagulant function change,and further analysis of the severity of AP patients associated with coagulant function change,at the same time draw the blood clotting index of the subjects work curve(ROC curve),the sensitivity index is calculated each specific degrees,about an index,the area under the curve,ROC curve analysis was used to evaluate the diagnostic value of coagulation indicators on the severity of AP patients,providing a theoretical basis for clinicians to accurately predict and evaluate the severity of AP.(P<0.05 was considered statistically significant.)Results:1.The changes of coagulation indexes in the MSAP+SAP group were significantly higher than those in the MAP group(P < 0.01).Further analysis showed that coagulation indexes(PT,APTT,Fib and D-D)were closely related to the severity of AP patients,and the absolute values of correlation coefficients of PT,APTT,Fib and D-D were respectively:0.503,0.526,0.442,and 0.508 were moderately correlated with the severity of acute pancreatitis(0.4 < r < 0.6).The ROC curve was then drawn,showing that PT,APTT,Fib,and D-D had diagnostic value for THE severity of AP,especially DD-D had high predictive value for the severity of AP.2.The level of coagulation indexes in the SIRS and sepsis groups was significantly higher than that in the SIRS and sepsis groups(P < 0.01),and the change of coagulation function in AP patients with TPOF and PMOF was significantly higher than that in the MOF group(P < 0.05).3.The coagulation indexes of AP patients in the death group and the improvement group were significantly higher than those in the cure group(P < 0.05).4.Six AP patients complicated with portal venous thrombosis,and the coagulation indexes in the group with thrombosis were significantly higher than those in the group without thrombosis(P < 0.01).When the coagulation indexes were significantly changed,late thrombosis should be warned.5.Correlation analysis showed that there was a linear negative correlation between Ca and AP coagulation indexes,while LDH,Cr,2-microglobulin,PCT was linearly positive correlation with coagulation indexes(r>0.2).The correlation coefficients between PCT and coagulation indexes were 0.672,0.666,0.612 and 0.631 respectively,and the changes of PCT and coagulation indexes were significantly correlated.Conclusions: 1.The change of coagulation function in AP patients has certain predictive value for the judgment of severity,outcome and prognosis of AP,especially when the D-D value reaches the threshold value,attention should be drawn.2.Changes in coagulation system in AP patients are related to SIRS,and the changes in coagulation function are more obvious in patients with SIRS.When AP patients were combined with PMOF and sepsis,the more significant the change of coagulation function was,the worse the prognosis was.3.When the coagulation indexes of AP patients change significantly,the possibility of portal vein thrombosis should be paid attention to,and low molecular weight heparin sodium can be used to prevent early in clinical practice.4.The change of PCT is consistent with the change of coagulation indicators.The more severe the infection is,the more the coagulation system disorder is aggravated.