Yarkaç Akif, Kose Ataman, Bozkurt Babuş Seyran, Ates Fehmi, Orekici Temel Gülhan, Ölmez Aydemir
Şanlıurfa Bilecik State Hospi̇tal Department of Emergency Medicine, Şanlıurfa-Turkey.
Department of Emergency Medicine, Mersin University Faculty of Medicine, Mersin-Turkey.
Ulus Travma Acil Cerrahi Derg. 2019 Sep;25(5):453-460. doi: 10.5505/tjtes.2018.69857.
Acute pancreatitis (AP) is a common inflammatory disease in the emergency department (ED). This study aims to assess the role of CRP and hematologic parameters in mild/severe AP patients and biliary/nonbiliary AP at the time of admission to the ED.
168 patients who were diagnosed as AP in the ED, and as a control group, 100 patients were included in this study. At the time of application to the ED, the demographic information (age, sex) and the amylase, lipase, CRP, hematological parameters (WBC, MPV, RDW, PLT, NLR) of all patients and the control group were recorded and compared. According to the etiology of the patients, the patients were divided into biliary and nonbilary AP groups and according to the severity, they were divided into mild and severe AP groups, then, the same parameters were evaluated.
Significant differences were found out between WBC, CRP, NLR, MPV and PLT values between patient and the control group (p<0.001). The length of hospitalization and the parameters were not significant between the biliary and the nonbiliary group. Ranson and APACHE II scores were correlated with WBC, CRP and NLR. There was a statistically significant difference between the mild and severe AP groups in terms of duration of the hospital stay, CRP, WBC and NLR values (p=0.003 for CRP, p<0.001 for the others). In severe AP, the cut-off value of NLR was found to be 8.05, sensitivity %93.48, specificity %86.89 and AUC 0.937 (p<0.001).
The use of parameters, such as WBC, CRP, and NLR, in combination with other diagnostic and prognostic tools in emergency service can provide convenience to clinicians at the time of admission and prognosis.
急性胰腺炎(AP)是急诊科常见的炎症性疾病。本研究旨在评估急诊科收治时,C反应蛋白(CRP)和血液学参数在轻度/重度AP患者以及胆源性/非胆源性AP中的作用。
本研究纳入了168例在急诊科被诊断为AP的患者,并将100例患者作为对照组。在患者到急诊科就诊时,记录并比较所有患者及对照组的人口统计学信息(年龄、性别)以及淀粉酶、脂肪酶、CRP、血液学参数(白细胞、平均血小板体积、红细胞分布宽度、血小板计数、中性粒细胞与淋巴细胞比值)。根据患者病因,将患者分为胆源性和非胆源性AP组,根据病情严重程度分为轻度和重度AP组,然后评估相同参数。
患者组与对照组在白细胞、CRP、中性粒细胞与淋巴细胞比值、平均血小板体积和血小板计数的值之间存在显著差异(p<0.001)。胆源性组和非胆源性组之间的住院时间和参数无显著差异。兰森和急性生理与慢性健康状况评分系统(APACHE II)评分与白细胞、CRP和中性粒细胞与淋巴细胞比值相关。轻度和重度AP组在住院时间、CRP、白细胞和中性粒细胞与淋巴细胞比值的值方面存在统计学显著差异(CRP为p = 0.003,其他为p<0.001)。在重度AP中,中性粒细胞与淋巴细胞比值的截断值为8.05,敏感性为93.48%,特异性为86.89%,曲线下面积为0.937(p<0.001)。
在急诊服务中,将白细胞、CRP和中性粒细胞与淋巴细胞比值等参数与其他诊断和预后工具结合使用,可为临床医生在入院和预后判断时提供便利。