Studies Of PCT,PCT/LAC,LPS And Severe Acute Pancreatitis Combined With Early Bacterial Infection

Objective: To explore the correlation between PCT,PCT/LAC,LPS and SAP combined with early bacterial infection.Methods: From December 2017 to April 2022,sap was diagnosed in the Affiliated Hospital of Guilin Medical College of 70 patients were studied.Sap patients were divided into infected and non-infected groups based on co-infection.Grouped according to etiology.Mann-Whitney U test was used to compare the differences of PCT,PCT/LAC and LPS between infected group and non-infected group.The area under curve,sensitivity,specificity and best cut-off value of PCT,PCT/LAC and LPS were calculated by ROC curve.Spearman rank correlation was used to compare the correlation of PCT,PCT/LAC,LPS and SAP with bacterial infection in different etiological groups.Results: Among the 70 SAP patients,36 were in the group with bacterial infection and 34 in the non-infected group,and 28 cases(40.4%)were biliary SAP patients,12 cases(17.2%)of alcoholic SAP,24 cases(34.3%)of hyperlipidemia SAP,surgical trauma SAP 5 cases(7.1%),other causes(including infection,drugs,etc.)1 case(1.4%).There was no statistical significance in the SAP co-bacterial infection group and non-infected age and sex(P>0.05).There were no statistical differences in PCT,PCT/LAC,and LPS in the etiological grouping(P >0.05).The accuracy of PCT and PCT/LAC in early prediction of SAP complicated with bacterial infection was moderate(AUC:0.886,0.852).The sensitivity and specificity of PCT were 88.9%,76.5%,respectively,and the best cut-off value was1.29ng/ml.The sensitivity of co-bacterial infection was 80.6%,the specificity was 82.4%,and the truncation value was 1.26;The accuracy of LPS early prediction of SAP combined with bacterial infection was low(AUC=0.685),the sensitivity was 58.3%,the specificity was 88.2%,and the cut-off value was 0.976pg/ml.In SAP caused by biliary origin,LPS was positively correlated with SAP with bacterial infection,while in SAP caused by alcoholism and hyperlipidemia,LP S was not significantly correlated with SAP with bacterial infection.LPS combined with PCT/LAC early prediction of SAP co-bacterial infection AUC=0.855,sensitivity 72.2%,specificity 91.2%;PCT combined with LPS early prediction of SAP co-bacterial infection with AUC =0.901,sensitivity of89.0% and specificity of 88.6%;AUC of PCT combined with PCT/LAC early prediction of early SAP co-bacterial infection = 0.886.The sensitivity was88.9% and the specificity was 76.4%.The sensitivity and specificity of the three indexes for predicting SAP complicated with bacterial infection of AUC=0.890 were 88.9% and 79.4% respectively.Conclusion: PCT and PCT/LAC have good diagnostic value for early SAP with bacterial infection;the combined application of LPS and PCT is more accurate;th ere is a positive correlation between LPS and SAP with bacterial infection in biliary SAP.There was no significant correlation between LPS and non-biliary SAP complicated with bacterial infection.PCT and PCT/LAC were positively corr elated with the occurrence of bacterial infection in SAP with different etiology.