| [Objectives]To explore the value of blood routine inflammation indexes in assessing the severity and prognosis of acute pancreatitis,and to determine the best predictor,in order to provide scientific guidance for the clinical treatment of AP.[Methods]A total of 312 AP patients who met the enrollment criteria who were hospitalized in a tertiary A hospital in Dali State from September 1,2018 to July 30,2020 were collected as the research objects.General data of all the research objects including basic information,Blood biochemical indicators,CT and other imaging examinations,systemic and local complications,disease severity and treatment methods,etc.Patients with acute pancreatitis were divided into three groups: MAP,MSAP and SAP;according to whether organ failure occurred,they were divided into two groups: organ failure group(OF group)and non-organ failure group(non-OF group).Detect and calculate the levels of NLR,PLR,MLR,RPR,RDW in the peripheral blood 24 hours after admission.Through statistical analysis,explore the value of blood routine inflammation indicators in the severity and prognosis of acute pancreatitis,and determine The best predictor.[Results]1.Gender,age,ethnicity and etiology(including hyperlipidemia,biliary origin,alcoholic and other causes,there is no significant difference among the three groups(mild group,moderate group,severe group)(P< 0.05)2.The white blood cells,neutrophils,lymphocytes,monocytes,PT,AST,blood calcium,blood sugar,urea,creatinine,days of hospitalization,and albumin in patients with acute pancreatitis are statistically different among different severity groups.Significance(P<0.05),while the levels of platelets,APTT,ALT,and total serum bilirubin were not significantly different(P>0.05).3.The NLR,PLR,MLR,RPR,RDW of the SAP group were significantly higher than those of the MAP group and MSAP group(P<0.05).4.NLR,PLR,MLR,RPR,RDW in OF group were higher than non-OF group(P<0.05).5.ROC curve results show: NLR,PLR,RDW,MLR,RPR can predict the severity of AP and the occurrence of organ failure,and when the indicators are at the best critical value,NLR has a good effect on the diagnosis of AP,The critical values for predicting severe and organ failure are 5.37 and 6.05,respectively.The sensitivity is79.5% and 74.5%,and the specificity is 77.9% and 79.6%.6.When the cut-off value of serum NLR was 5.37 to divide all patients with acute pancreatitis into 2 groups,118 patients with serum NLR≥5.37 showed a worse prognosis than 194 patients with serum NLR<5.37.In the high NLR group,severe acute pancreatitis(57.6%),PN(13.6%),OF(62.9%),hemodialysis treatment after admission(28.8%),vasoactive drug maintenance treatment(10.2%),admission to ICU(35.6%)The incidence of)and mortality(5.9%)was higher.In addition,the high NLR group had higher blood glucose,urea,SOAF scores,and BISAP scores,and lower blood calcium,with significant statistical differences(P<0.05).Correlation analysis was used to compare the relationship between NLR and SOAF score and BISAP score.The results showed that NLR was positively correlated with SOAF score and BISAP score(r=0.385,P<0.001;r=0.441,P<0.001).[Conclusions]1.As the severity of AP increases,NLR,PLR,RDW,MLR,and RPR gradually increase;and NLR is more clinically meaningful than other indicators to predict the severity of AP and the occurrence of organ failure.2.The higher the NLR of AP patients,the worse the prognosis.The dynamic monitoring of the level of NLR in patients with acute pancreatitis can be used as one of the effective indicators to evaluate the severity of the disease. |
