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预测急诊科急性胰腺炎严重程度的新标志物:未成熟粒细胞计数和百分比。

New markers in predicting the severity of acute pancreatitis in the emergency department: Immature granulocyte count and percentage.

机构信息

Health Science University Antalya Training and Research Hospital, Department of Emergency Medicine, Antalya, Turkey.

出版信息

J Postgrad Med. 2021 Jan-Mar;67(1):7-11. doi: 10.4103/jpgm.JPGM_784_20.

Abstract

BACKGROUND

Acute pancreatitis (AP) may vary in severity, from mild, self-limiting pancreatic inflammation to rapidly progressive life-threatening clinical course. If the severity of AP can be predicted early and treated quickly, it may lead to a decrease in morbidity and mortality rates. There?fore, we aimed to investigate the clinical utility of immature granulocyte count (IGC) and IGC percentage (IG%) in showing the severity of AP in this study.

METHODS

Two hundred and twenty-seven patients who were admitted to our emergency department and diagnosed with AP between March 1 and September 30, 2019, were included in the study. The patients were divided into two groups as mild and severe AP (MAP and SAP) according to the severity of the disease. Demographic characteristics of the patients, disease etiology, disease severity, and inflammation markers [white blood cell count (WBC), IGC, IG%, neutrophil-lymphocyte ratio (NLR), and C-reactive protein (CRP)] were recorded. Differences between the groups were statistically analyzed.

RESULTS

Of the patients included in the study, 183 (80.7%) were in the MAP group and 44 (19.3%) were in the SAP group. The mean WBC, NLR, CRP, IGC, and IG% levels were significantly higher in the SAP group compared to the MAP group. The power of IGC and IG% in predicting SAP was higher than other inflammation markers (WBC, NLR, and CRP) [(AUC for IGC: 0.902; sensitivity: 78.2%; specificity: 92.8%); (AUC for IG%: 0.843; sensitivity: 72.7%; specificity: 84.6%)].

CONCLUSION

IGC and IG% show the severity of AP more effectively than WBC, NLR, and CRP, which are traditional inflammation markers.

摘要

背景

急性胰腺炎(AP)的严重程度可从轻度、自限性胰腺炎症变化为快速进展的危及生命的临床病程。如果能早期预测 AP 的严重程度并迅速治疗,可能会降低发病率和死亡率。因此,我们旨在研究不成熟粒细胞计数(IGC)和 IGC 百分比(IG%)在显示 AP 严重程度方面的临床效用。

方法

本研究纳入了 2019 年 3 月 1 日至 9 月 30 日期间因 AP 入住我院急诊科的 227 例患者。根据疾病严重程度,将患者分为轻症急性胰腺炎(MAP)和重症急性胰腺炎(SAP)两组。记录患者的人口统计学特征、病因、疾病严重程度和炎症标志物[白细胞计数(WBC)、IGC、IG%、中性粒细胞-淋巴细胞比值(NLR)和 C 反应蛋白(CRP)]。对组间差异进行统计学分析。

结果

在本研究中,183 例(80.7%)患者为 MAP 组,44 例(19.3%)患者为 SAP 组。SAP 组的 WBC、NLR、CRP、IGC 和 IG%水平均显著高于 MAP 组。与其他炎症标志物(WBC、NLR 和 CRP)相比,IGC 和 IG% 预测 SAP 的效能更高[IGC 的 AUC:0.902;灵敏度:78.2%;特异性:92.8%;IG%的 AUC:0.843;灵敏度:72.7%;特异性:84.6%]。

结论

与传统炎症标志物 WBC、NLR 和 CRP 相比,IGC 和 IG% 能更有效地反映 AP 的严重程度。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3d8c/8098866/12521ea80cdf/JPGM-67-7-g001.jpg

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