Kolosovych Ihor, Hanol Ihor, Bystrytska Maryna, Uzun Halil
Department of Surgery #2, Bogomolets National Medical Unıversity, Kyiv, Ukraine.
Turk J Surg. 2022 Dec 20;38(4):327-333. doi: 10.47717/turkjsurg.2022.5669. eCollection 2022 Dec.
The problem of predicting the course of acute pancreatitis and early diagnosis of its complications remains unresolved. This study aimed to determine changes in vitamin D and calcium-phosphorus metabolism in patients with severe acute pancreatitis.
There were examined 72 people divided into two groups as healthy persons (comparison group) - males and females without pathology of the gastrointestinal tract and any other conditions or diseases that could affect the state of calcium-phosphorus metabolism (n= 36) and patients with acute pancreatitis (main group, n= 36). In addition, in order to determine the prognostic criteria for the severity of the disease, patients in the main group were divided into two subgroups. The first subgroup included patients with severe disease (n= 18), the second (n= 18) - with mild and moderate disease.
Serum calcium value was lower in patients with severe acute pancreatitis comparison to healthy persons: 2.18 (2.12; 2.34) vs 2.36 (2.31; 2.43) mmol/L (p <0.0001), and the decrease of calcium levels was associated with an increase in the severity of acute pancreatitis. Therefore, hypocalcemia can be considered a reliable predictor of the severity of the disease. In patients with acute pancreatitis, the level of vitamin D was significantly low than in the healthy persons and was 13.8 (9.03; 21.34) and 28.4 (21.8; 32.3) ng/mL, respectively (p <0.0001).
For patients with acute pancreatitis, serum vitamin D levels≤ 13.28 ng/mL can be considered as a significant predictor of severe disease (sensitivity 83.3%, specificity 94.4%) regardless of calcium level.
预测急性胰腺炎病程及早期诊断其并发症的问题仍未解决。本研究旨在确定重症急性胰腺炎患者维生素D及钙磷代谢的变化。
对72人进行了检查，分为两组，即健康人（对照组）——无胃肠道疾病及任何其他可能影响钙磷代谢状态的疾病的男性和女性（n = 36）以及急性胰腺炎患者（主要组，n = 36）。此外，为了确定疾病严重程度的预后标准，主要组患者被分为两个亚组。第一个亚组包括重症患者（n = 18），第二个亚组（n = 18）——轻症和中症患者。
重症急性胰腺炎患者的血清钙值低于健康人：2.18（2.12；2.34）mmol/L 对比 2.36（2.31；2.43）mmol/L（p <0.0001），且钙水平降低与急性胰腺炎严重程度增加相关。因此，低钙血症可被视为疾病严重程度的可靠预测指标。急性胰腺炎患者的维生素D水平显著低于健康人，分别为13.8（9.03；21.34）和28.4（21.8；32.3）ng/mL（p <0.0001）。
对于急性胰腺炎患者，无论钙水平如何，血清维生素D水平≤13.28 ng/mL可被视为重症疾病（敏感性83.3%，特异性94.4%）的重要预测指标。
