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C 反应蛋白/白蛋白比值在急性胰腺炎中的预测价值。

Predictive value of C-reactive protein/albumin ratio in acute pancreatitis.

机构信息

Department of Gastroenterology, Turkey Yuksek Ihtisas Training and Research Hospital, Ankara 06100, Turkey.

Department of Internal Medicine, Ankara Numune Training and Research Hospital, Ankara 06100, Turkey.

出版信息

Hepatobiliary Pancreat Dis Int. 2017 Aug 15;16(4):424-430. doi: 10.1016/S1499-3872(17)60007-9.

Abstract

BACKGROUND

Serum C-reactive protein (CRP) increases and albumin decreases in patients with inflammation and infection. However, their role in patients with acute pancreatitis is not clear. The present study was to investigate the predictive significance of the CRP/albumin ratio for the prognosis and mortality in acute pancreatitis patients.

METHODS

This study was performed retrospectively with 192 acute pancreatitis patients between January 2002 and June 2015. Ranson scores, Atlanta classification and CRP/albumin ratios of the patients were calculated.

RESULTS

The CRP/albumin ratio was higher in deceased patients compared to survivors. The CRP/albumin ratio was positively correlated with Ranson score and Atlanta classification in particular and with important prognostic markers such as hospitalization time, CRP and erythrocyte sedimentation rate. In addition to the CRP/albumin ratio, necrotizing pancreatitis type, moderately severe and severe Atlanta classification, and total Ranson score were independent risk factors of mortality. It was found that an increase of 1 unit in the CRP/albumin ratio resulted in an increase of 1.52 times in mortality risk. A prediction value about CRP/albumin ratio >16.28 was found to be a significant marker in predicting mortality with 92.1% sensitivity and 58.0% specificity. It was seen that Ranson and Atlanta classification were higher in patients with CRP/albumin ratio >16.28 compared with those with CRP/albumin ratio ≤16.28. Patients with CRP/albumin ratio >16.28 had a 19.3 times higher chance of death.

CONCLUSION

The CRP/albumin ratio is a novel but promising, easy-to-measure, repeatable, non-invasive inflammation-based prognostic score in acute pancreatitis.

摘要

背景

血清 C 反应蛋白(CRP)在炎症和感染患者中升高,白蛋白降低。然而,其在急性胰腺炎患者中的作用尚不清楚。本研究旨在探讨 CRP/白蛋白比值对急性胰腺炎患者预后和死亡率的预测意义。

方法

本研究回顾性分析了 2002 年 1 月至 2015 年 6 月期间 192 例急性胰腺炎患者。计算了患者的 Ranson 评分、亚特兰大分类和 CRP/白蛋白比值。

结果

死亡患者的 CRP/白蛋白比值高于存活患者。CRP/白蛋白比值与 Ranson 评分和亚特兰大分类呈正相关,与住院时间、CRP 和红细胞沉降率等重要预后标志物也呈正相关。除 CRP/白蛋白比值外,坏死性胰腺炎类型、中重度和重度亚特兰大分类以及总 Ranson 评分是死亡率的独立危险因素。发现 CRP/白蛋白比值增加 1 个单位,死亡率风险增加 1.52 倍。发现 CRP/白蛋白比值>16.28 是死亡率的一个显著预测标志物,其敏感性为 92.1%,特异性为 58.0%。与 CRP/白蛋白比值≤16.28 的患者相比,CRP/白蛋白比值>16.28 的患者 Ranson 和亚特兰大分类更高。CRP/白蛋白比值>16.28 的患者死亡风险增加 19.3 倍。

结论

CRP/白蛋白比值是一种新颖但有前途的、易于测量、可重复、非侵入性的基于炎症的急性胰腺炎预后评分。

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