未成熟粒细胞在急性胰腺炎患者中的预后价值。
The prognostic value of immature granulocyte in patients with acute pancreatitis.
作者信息
Karakulak Serkan, Narcı Hüseyin, Ayrık Cüneyt, Erdoğan Semra, Üçbilek Enver
机构信息
Mersin University, Faculty of Medicine, Department of Emergency Medicine, Mersin, Turkey.
Mersin University, Faculty of Medicine, Department of Emergency Medicine, Mersin, Turkey.
出版信息
Am J Emerg Med. 2021 Jun;44:203-207. doi: 10.1016/j.ajem.2020.03.028. Epub 2020 Mar 19.
BACKGROUND
Acute pancreatitis is the inflammation of the pancreas. It can range from mild forms to life-threatening severe cases. There is not yet a marker that can detect severe cases in the early period. Early diagnosis and treatment of this disease has critical importance for prognosis. In this study, we aimed to investigate the percentage of immature granulocyte (IG %) in patients with acute pancreatitis in order to predict the severity of the disease and in-hospital mortality.
METHOD
This study was carried out retrospectively in academic emergency department (ED), faculty of medicine between 01.01.2017 and 30.06.2019. The patients were divided into three groups as mild, moderate and severe. In addition, the patients were divided into two groups: those discharged from the hospital and those who died in the hospital. IG % and other laboratory parameters of the patients were recorded in the study form. The primary outcome for this study is the value of IG% in predicting severity in AP patients. A receiver operating characteristic (ROC) curve analysis was performed.
RESULTS
A total of 218 patients (107 male) were included in the study. The mean age of the patients was 56.9 ± 18.3 years. It was found that IG% levels were higher in patients with severe pancreatitis (p = .018). In the ROC analysis that was done to determine the severity of the disease, the cut-off value of IG% was found as >1.1. As such case, specificity was %38.89, sensitivity was 95.00%, positive predictive value (PPV) was 41.18% and negative predictive value (NPV) was found as 94.53% (Area Under Curve (AUC) = 0.698). In ROC analysis that was performed to determine in-hospital mortality, the cut-off value of IG level was found as >1.8, sensitivity was 50.00%, specificity was 97.12%, PPV was 45.45% and NPV was found as 97.58% (AUC = 0.708). CONCLUSıONS: This study shows that higher IG% levels may correlate with higher disease severity and in-hospital mortality in patients with acute pancreatitis.
背景
急性胰腺炎是胰腺的炎症。其病情从轻度到危及生命的严重程度不等。目前尚无能够在疾病早期检测出严重病例的标志物。该疾病的早期诊断和治疗对预后至关重要。在本研究中，我们旨在调查急性胰腺炎患者中未成熟粒细胞百分比（IG%），以预测疾病的严重程度和住院死亡率。
方法
本研究于2017年1月1日至2019年6月30日在医学院校学术急诊科进行回顾性研究。患者分为轻度、中度和重度三组。此外，患者还分为两组：出院患者和住院死亡患者。患者的IG%及其他实验室参数记录在研究表格中。本研究的主要结果是IG%在预测急性胰腺炎患者病情严重程度方面的价值。进行了受试者操作特征（ROC）曲线分析。
结果
本研究共纳入218例患者（107例男性）。患者的平均年龄为56.9±18.3岁。发现重症胰腺炎患者的IG%水平较高（p = 0.018）。在确定疾病严重程度的ROC分析中，IG%的截断值为>1.1。此时，特异性为38.89%，敏感性为95.00%，阳性预测值（PPV）为41.18%，阴性预测值（NPV）为94.53%（曲线下面积（AUC）= 0.698）。在确定住院死亡率的ROC分析中，IG水平的截断值为>1.8，敏感性为50.00%，特异性为97.12%，PPV为45.45%，NPV为97.58%（AUC = 0.708）。结论：本研究表明，急性胰腺炎患者中较高的IG%水平可能与更高的疾病严重程度和住院死亡率相关。
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