| Objective: to study the value of laboratory indexes in the early stage of acute pancreatitis(within 24 hours)on the severity of acute pancreatitis.Methods: the clinical data of 187 patients with AP in the first affiliated Hospital of Xinjiang Medical University from January 2018 to December 2019 were collected retrospectively,including general clinical data and inflammatory indexes.According to the diagnostic criteria of acute pancreatitis,patients with acute pancreatitis were divided into SAP group and non-SAP group.The statistical data of the subjects were analyzed by SPSS26.0 and Medcalc19.4.1statistical software.the differences of laboratory indexes such as CRP,PCT,IL-6,RDW and NLR were compared between the two groups.Logistic regression analysis and ROC curve were used to calculate the area under the curve,95%confidence interval,optimal threshold,sensitivity and specificity,and Kappa test was used to analyze the consistency with the gold standard.Results: 1)in the SAP group,there were 40 males,accounting for 67.67% of the total females,accounting for 33.33%.The youngest was 26 years old,the oldest was 82 years old,and the average age was 49.98 ±15.457.In the non-SAP group,there were83 males(65.4%)and 44 females(34.5%).The minimum age was 18 years old,the maximum age was 88 years old,and the average age was 46.34 ±14.087.There was no significant difference in the distribution of age and sex between the two groups(P > 0.05).2)the levels of serum CRP,PCT,RDW,IL-6 and NLR in SAP group were significantly higher than those in non-SAP group.3)the sensitivity and specificity of CRP,PCT,IL-6,RDW,NLR and AUC for the evaluation of early acute pancreatitis were 0.718,0.772,0.738,0.657 and 0.760,respectively,and the sensitivity and specificity were 55.00%,81.67%,48.33%,66.67%,63.33%,53.33% and 87.40%,66.14%,90.55%,59.06%,92.1%,respectively.The optimal thresholds are 78.44mg/L,0.14ng/L,170.8pg/L,12.7% and 10.05,respectively.Among them,only the predictive ability of CRP and IL-6 had statistical significance,the AUC area of the combined detection was(0.760),and the specificity was the highest(92.91%),PCT had the best sensitivity(81.67%).4)the sensitivity of the combination of IL-6 and CRP in the evaluation of SAP is the best(82.61%),but the consistency is poor.The Kappa value is 0.341,and the specificity of SAP is the highest(90.55%),and the Kappa value is 0.424.)the parallel evaluation of IL-6 and CRP for SAP has an AUC area of 0.764,a sensitivity of 64.18%,a specificity of 85.83%,and a moderate consistency,with a Kappa value of 0.512.Conclusion: 1.CRP IL copyright 6 PCT ～ RDW ～ NLR can be used as a positive correlation between the early stage(within 24 hours)and the severity of acute pancreatitis,and it is an index to evaluate the severity of acute pancreatitis.2.PCT is a good single index to evaluate the severity of early AP.3RDW and NLR are simple,easy to obtain,cheap and reliable indicators to evaluate the severity of AP in the early stage.(4)it is effective to evaluate the severity of AP patients in the early stage(within 24 hours)by combining CRP,IL-6,PCT,RDW,NLR. |
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