血清白蛋白是急性胰腺炎持续性器官衰竭的良好指标。
Serum albumin, a good indicator of persistent organ failure in acute pancreatitis.
作者信息
Li Shoukang, Zhang Yushun, Li Mengjiao, Xie Chao, Wu Heshui
机构信息
Pancreatic Disease Institute, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, 430022, Wuhan, Hubei Province, People's Republic of China.
Department of Endocrinology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, 430022, Wuhan, Hubei Province, People's Republic of China.
出版信息
BMC Gastroenterol. 2017 Apr 26;17(1):59. doi: 10.1186/s12876-017-0615-8.
BACKGROUND
To evaluate the predictive value of serum albumin (ALB) for persistent organ failure (POF) in acute pancreatitis (AP).
METHODS
We selected 158 patients with AP in this retrospective study from Jan.1st, 2015 to Dec.31st, 2015. Forty-six patients were diagnosed with POF. All the values of laboratory parameters were measured upon admission to hospital. And 48 h after admission, we examined serum albumin of each patient again, called 'ALB2'. Uni-and multi-variate logistic regression were used to evaluate the impact of ALB to predict POF.
RESULTS
The median age of the whole population was 48 years and 53.8% were male. The admission-time albumin of AP patients with POF was distinctly lower than patients without POF (28.9 (25.3-33.1) g/L vs. 38.5 (34.0-40.1) g/L, p < 0.001). In uni-variate analysis, WBC, PT, GLU, LDH, ALB, ALB2, BUN, Ca, HDL-C and Ranson were significantly associated with POF. After multivariate regression, ALB remained an independent prognostic factor for POF in AP (OR: 0.748, 95%CI: 0.645-0.868; p < 0.05). The AUC for ALB is 0.873 (0.808, 0.938), even larger than that for Ranson, 0.845 (0.634, 0.913).
CONCLUSIONS
We identified serum albumin predictive to persistent organ failure in acute pancreatitis.
背景
评估血清白蛋白（ALB）对急性胰腺炎（AP）患者持续性器官衰竭（POF）的预测价值。
方法
在这项回顾性研究中，我们选取了2015年1月1日至2015年12月31日期间的158例AP患者。其中46例被诊断为POF。所有实验室参数值均在入院时测定。入院48小时后，再次检测每位患者的血清白蛋白，称为“ALB2”。采用单因素和多因素逻辑回归分析评估ALB对POF的预测影响。
结果
总体人群的中位年龄为48岁，男性占53.8%。发生POF的AP患者入院时的白蛋白水平明显低于未发生POF的患者（28.9（25.3 - 33.1）g/L对38.5（34.0 - 40.1）g/L，p < 0.001）。单因素分析中，白细胞（WBC）、凝血酶原时间（PT）、血糖（GLU）、乳酸脱氢酶（LDH）、ALB、ALB2、血尿素氮（BUN）、钙（Ca）、高密度脂蛋白胆固醇（HDL-C）和兰森（Ranson）评分与POF显著相关。多因素回归分析后，ALB仍是AP患者POF的独立预后因素（OR：0.748，95%CI：0.645 - 0.868；p < 0.05）。ALB的曲线下面积（AUC）为0.873（0.808，0.938），甚至大于兰森评分的AUC，即0.845（0.634，0.913）。
结论
我们确定血清白蛋白对急性胰腺炎患者的持续性器官衰竭具有预测作用。
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