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在评估儿童急性胰腺炎严重程度时,全身炎症反应综合征评分与C反应蛋白水平的联合应用

Amalgamation of systemic inflammatory response syndrome score with C-reactive protein level in evaluating acute pancreatitis severity in children.

作者信息

Zheng Wei, Zhang Linqian, Long Gao, Chen Bo, Shu Xiaoli, Jiang Mizu

机构信息

a Department of Gastroenterology , Children's Hospital, Zhejiang University School of Medicine , Hangzhou , Zhejiang , P. R. China.

出版信息

Scand J Gastroenterol. 2018 Jun;53(6):755-759. doi: 10.1080/00365521.2018.1459825. Epub 2018 Apr 12.

Abstract

BACKGROUND AND AIM

Systemic inflammatory response syndrome (SIRS) has to do with how the body reacts to injury. Herein, we analyzed the clinical features of acute pancreatitis (AP) in children with SIRS complication and investigated the role of SIRS score combined with C-reactive protein (CRP) level in assessing AP severity in children.

METHODS

This retrospective cohort study involved 111 children hospitalized with AP at the Children's Hospital of Zhejiang University School of Medicine between January 2012 and August 2017. Presence of SIRS, demographic data, clinical information and laboratory test results on admission were statistically examined.

RESULTS

Out of the 111 AP cases, 45 were diagnosed with SIRS. Differences in CRP, interleukin-6 (IL-6), age, temperature, heart rate (HR), white blood cell (WBC), neutrophil count (NC), body mass index (BMI), duration of onset of disease symptoms as well as cases requiring intensive care unit (ICU) treatment were significantly higher in patients with SIRS than those without SIRS (p < .01 or p < .05). Logistic regression analyses evinced two independent risk factors for SIRS to be coexisted diseases (odds ratio (OR) = 4.871, p = .02) and fever (OR = 3.56, p = .007). SIRS was an independent predictor for AP severity (OR = 10.820, p = .005). The optimal cut-off value of CRP was 27.5 mg/L for severe AP classification according to receiver operating characteristic (ROC) (area under curve was 0.733).

CONCLUSION

Amalgamation of SIRS criterion with CRP level potentially plays an important role in assessing AP severity in children.

摘要

背景与目的

全身炎症反应综合征(SIRS)与机体对损伤的反应有关。在此,我们分析了并发SIRS的儿童急性胰腺炎(AP)的临床特征,并探讨了SIRS评分联合C反应蛋白(CRP)水平在评估儿童AP严重程度中的作用。

方法

这项回顾性队列研究纳入了2012年1月至2017年8月在浙江大学医学院附属儿童医院住院的111例AP患儿。对入院时SIRS的存在情况、人口统计学数据、临床信息和实验室检查结果进行统计学分析。

结果

111例AP病例中,45例被诊断为SIRS。SIRS患者的CRP、白细胞介素-6(IL-6)、年龄、体温、心率(HR)、白细胞(WBC)、中性粒细胞计数(NC)、体重指数(BMI)、疾病症状发作持续时间以及需要重症监护病房(ICU)治疗的病例数均显著高于无SIRS的患者(p <.01或p <.05)。Logistic回归分析表明,SIRS的两个独立危险因素为并存疾病(比值比(OR)= 4.871,p =.02)和发热(OR = 3.56,p =.007)。SIRS是AP严重程度的独立预测因素(OR = 10.820,p =.005)。根据受试者工作特征(ROC)曲线,CRP用于重度AP分类的最佳截断值为27.5 mg/L(曲线下面积为0.733)。

结论

SIRS标准与CRP水平的联合应用在评估儿童AP严重程度方面可能发挥重要作用。

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