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C 反应蛋白/白蛋白比值作为急性胰腺炎预后标志物的价值:一项回顾性研究。

Value of CRP/albumin ratio as a prognostic marker of acute pancreatitis: a retrospective study.

机构信息

Gastroenterology, Hospital Clínico Universitario de Valladolid, Spain.

Gastroenterology, Hospital Clínico Universitario de Valladolid, España.

出版信息

Rev Esp Enferm Dig. 2023 Dec;115(12):707-712. doi: 10.17235/reed.2023.9345/2022.

Abstract

INTRODUCTION

the C-reactive protein (CRP) to albumin ratio is an inflammatory marker that has shown promise in the prognosis of critically ill patients. This study is aimed to assess the value of CRP/albumin ratio to predict severity in acute pancreatitis.

METHODS

a retrospective study was performed using a prospectively collected database of patients diagnosed with AP admitted to the Department of Gastroenterology between March 2014 and December 2021.

RESULTS

among 722 patients included in the study, 78.67 % had mild, 15.65 % had moderately severe, and 5.67 % had severe acute pancreatitis. The CRP/albumin ratio was significantly associated with severe AP (OR 1.02; 95 % CI: 1.01-1.03; p < 0.001), and each ten-unit increase in the ratio was associated with a 20 % increased likelihood of severe acute pancreatitis. The area under the ROC curve (AUC) value of the CRP/albumin ratio in severe acute pancreatitis was 0.68 (95 % CI: 0.58-0.77), which was higher than that of the Ranson criteria (0.62). The optimal cut-off value for predicting severe acute pancreatitis was 7.51, with a sensitivity of 63.4 % and specificity of 65.6 %.

CONCLUSIONS

despite its low sensitivity and specificity, the CRP/albumin ratio could be used as a complementary marker to the current scoring systems for the initial assessment of acute pancreatitis prognosis. It is easily obtainable and can provide additional prognostic information to clinicians.

摘要

简介

C 反应蛋白(CRP)与白蛋白比值是一种炎症标志物,在危重症患者的预后评估中显示出良好的应用前景。本研究旨在评估 CRP/白蛋白比值预测急性胰腺炎严重程度的价值。

方法

采用回顾性研究方法,使用 2014 年 3 月至 2021 年 12 月期间在消化内科住院的诊断为 AP 的患者前瞻性收集数据库进行研究。

结果

在纳入的 722 例患者中,78.67%为轻症急性胰腺炎,15.65%为中度重症急性胰腺炎,5.67%为重症急性胰腺炎。CRP/白蛋白比值与重症急性胰腺炎显著相关(OR 1.02;95%CI:1.01-1.03;p<0.001),比值每增加 10 个单位,重症急性胰腺炎的可能性就增加 20%。CRP/白蛋白比值预测重症急性胰腺炎的 ROC 曲线下面积(AUC)值为 0.68(95%CI:0.58-0.77),高于 Ranson 标准(0.62)。预测重症急性胰腺炎的最佳截断值为 7.51,灵敏度为 63.4%,特异度为 65.6%。

结论

尽管 CRP/白蛋白比值的灵敏度和特异度均较低,但它可作为目前评分系统的补充标志物,用于急性胰腺炎初始预后评估。该比值易于获取,可以为临床医生提供额外的预后信息。

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