德尔塔中性粒细胞指数作为急诊科重症急性胰腺炎的早期预测标志物。
Delta neutrophil index as an early predictive marker of severe acute pancreatitis in the emergency department.
机构信息
Department of Emergency Medicine, Yonsei University Wonju College of Medicine, Wonju, Republic of Korea.
Department of Laboratory Medicine, Konyang University Hospital, Daejeon, Republic of Korea.
出版信息
United European Gastroenterol J. 2019 May;7(4):488-495. doi: 10.1177/2050640619838359. Epub 2019 Mar 14.
BACKGROUND
Predicting severe acute pancreatitis (AP) in the early clinical stage is important for low morbidity and mortality. Delta neutrophil index (DNI) is used to detect infection and inflammation, but no previous studies have evaluated the usefulness of DNI as an early predictor of progression to severe AP (SAP).
METHODS
The medical records of patients who were diagnosed with AP at the emergency department (ED) of Wonju Severance Christian Hospital from January 2012 to August 2016 were retrospectively reviewed. The initial DNI obtained in the ED was compared with other inflammatory markers to predict SAP. Multivariate logistic regression was used for statistical analysis.
RESULTS
Of the 209 cases included in the analysis, 13 were classified as SAP. Compared to the DNI of the mild to moderately SAP group, that in the SAP group was considerably higher. The DNI showed a positive correlation with the Atlanta classification and bedside index of severity in AP. Using multivariate logistic regression analysis, DNI was an independent predictor of early SAP detection (odds ratio 1.122, 95% CI 1.045-1.205, = 0.001). Among the biomarkers, DNI had the highest predictive value for SAP.
CONCLUSIONS
The DNI measured in the ED at presentation is a potentially useful adjunctive marker to predict SAP.
背景
在早期临床阶段预测重症急性胰腺炎（AP）对于降低发病率和死亡率非常重要。Delta 中性粒细胞指数（DNI）用于检测感染和炎症，但以前没有研究评估 DNI 作为预测重症 AP（SAP）进展的早期指标的有用性。
方法
回顾性分析了 2012 年 1 月至 2016 年 8 月在原州基督教医院急诊科诊断为 AP 的患者的病历。比较 ED 获得的初始 DNI 与其他炎症标志物，以预测 SAP。使用多变量逻辑回归进行统计分析。
结果
在纳入分析的 209 例中，有 13 例被分类为 SAP。与轻度至中度 SAP 组的 DNI 相比，SAP 组的 DNI 明显更高。DNI 与亚特兰大分类和 AP 的床边严重程度指数呈正相关。使用多变量逻辑回归分析，DNI 是早期 SAP 检测的独立预测因子（优势比 1.122，95%CI 1.045-1.205，P=0.001）。在这些生物标志物中，DNI 对 SAP 具有最高的预测价值。
结论
在急诊科就诊时测量的 DNI 是预测 SAP 的一种潜在有用的辅助标志物。
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