Cao Xi, Wang Huai-Ming, Du Hai, Chen Er-Xia, Yang Xiu-Feng, Wang Shi-Long, Ding Ya, She Zhan-Fei
Department of General Surgery, Ordos Central Hospital, Ordos, Inner Mongolia 017000, P.R. China.
CT-MRI Room, Ordos Central Hospital, Ordos, Inner Mongolia 017000, P.R. China.
Exp Ther Med. 2018 Nov;16(5):4232-4238. doi: 10.3892/etm.2018.6713. Epub 2018 Sep 10.
The present study aimed to investigate early risk factors for hyperlipidemic acute pancreatitis (HLAP) in order to open up novel routes for its prevention and treatment. Demographics, laboratory data obtained within 48 h, enhanced computed tomography (CT) imaging data and the modified CT severity index (MCTSI) for 111 patients with HLAP who were assessed at Ordos Central Hospital (Ordos, China) between January 2015 and October 2017 were retrospectively analyzed. Of these, 17 patients progressed to infectious pancreatic necrosis (IPN) and 14 patients progressed to organ failure (OF), the occurrence of which were the study outcomes. The patients were divided into pairs groups: IPN and non-IPN, as well as OF and non-OF, and differences between the groups were determined regarding various clinicopathological parameters. Furthermore, univariate and multivariate regression analyses were performed to identify parameters associated with the risk of progression to IPN or OP. On univariate analysis, the following parameters were deemed as being significantly associated with the risk of IPN: Serum calcium ions, C-reactive protein (CRP), extent of necrosis, procalcitonin (PTC) and the MCTSI. Furthermore, calcium ions, red cell distribution width (RDW), extent of necrosis and the MCTSI were significantly associated with the risk of OF on univariate analysis. Multivariate logistic regression analysis for these parameters then indicated that CRP (P=0.014), RDW (P=0.025) and the extent of necrosis (P=0.022) were significant and independent predictors of progression; thus, these are early risk factors for patients with HLAP. Receiver operating characteristic curves were generated to evaluate the predictive value of these factors, and the area under the curve for the three parameters was 0.863 [95% confidence interval (CI), 0.646-0.886], 0.727 (95% CI, 0.651-0.803) and 0.833 (95% CI, 0.739-0.936), respectively. Therefore, CRP, RDW and the extent of necrosis are early predictive indexes for the risk of progression in HLAP.
本研究旨在探讨高脂血症性急性胰腺炎（HLAP）的早期危险因素，以便为其预防和治疗开辟新途径。回顾性分析了2015年1月至2017年10月在鄂尔多斯市中心医院（中国鄂尔多斯）评估的111例HLAP患者的人口统计学资料、48小时内获得的实验室数据、增强计算机断层扫描（CT）影像数据以及改良CT严重程度指数（MCTSI）。其中，17例患者进展为感染性胰腺坏死（IPN），14例患者进展为器官衰竭（OF），其发生情况为研究结果。将患者分为配对组：IPN组和非IPN组，以及OF组和非OF组，并确定两组在各种临床病理参数方面的差异。此外，进行单因素和多因素回归分析以确定与进展为IPN或OF风险相关的参数。单因素分析时，以下参数被认为与IPN风险显著相关：血清钙离子、C反应蛋白（CRP）、坏死程度、降钙素原（PTC）和MCTSI。此外，单因素分析时，钙离子、红细胞分布宽度（RDW）、坏死程度和MCTSI与OF风险显著相关。对这些参数进行多因素逻辑回归分析，结果表明CRP（P=0.014）、RDW（P=0.025）和坏死程度（P=0.022）是进展的显著且独立预测因素；因此，这些是HLAP患者的早期危险因素。生成受试者工作特征曲线以评估这些因素的预测价值，这三个参数的曲线下面积分别为0.863[95%置信区间（CI），0.646 - 0.886]、0.727（95%CI，0.651 - 0.803）和0.833（95%CI，0.739 - 0.936）。因此，CRP、RDW和坏死程度是HLAP进展风险的早期预测指标。
