Stutee Isha, Midha Naresh K, Chaudhary Monika, Kumar Deepak, Banerjee Mithu, Garg Pawan, Soni Subhash, Garg Mahendra Kumar
General Medicine, All India Institute of Medical Sciences, Jodhpur, Jodhpur, IND.
Biochemistry, All India Institute of Medical Sciences, Jodhpur, Jodhpur, IND.
Cureus. 2025 Jul 30;17(7):e89033. doi: 10.7759/cureus.89033. eCollection 2025 Jul.
Background Acute pancreatitis (AP) is an inflammatory condition of the pancreas that varies in severity. Reliable prognostic markers are essential for early risk stratification. This study evaluates inflammatory markers and severity indices to predict disease outcomes. Aims This prospective observational study aims to assess the prognostic value of various inflammatory markers alongside the Bedside Index for Severity in Acute Pancreatitis (BISAP) and the Computed Tomography Severity Index (CTSI) in patients suffering from AP. Methods This study evaluated the prognostic significance of inflammatory markers in 80 patients with AP. Among these markers are the neutrophil-lymphocyte ratio (NLR), lymphocyte-monocyte ratio (LMR), platelet-lymphocyte ratio (PLR), red cell distribution width (RDW), C-reactive protein (CRP), interleukin-6 (IL-6), and lactate dehydrogenase (LDH). Their correlation with BISAP, CTSI, and Modified CTSI was also analyzed to enhance predictive accuracy. Results Out of 80 patients studied, alcohol was the most common cause, seen in 41 cases (51%). Gallstones were the next major etiology, found in 19 patients (24%). The age of participants ranged from 20 to 80 years, with a mean age of 40.9 ± 13.9 years. A clear male predominance was observed, with 60 (75%) patients being male. In this study, 17 patients (21%) had mild, 54 (68%) moderately severe, and nine (11%) severe pancreatitis. LDH was significantly higher in severe cases (p < 0.0001), with levels above 435 U/L predicting severity with 100% sensitivity and 66.8% specificity. NLR, LMR, and PLR declined significantly during recovery (p = 0.001). Higher LDH, BISAP, CTSI, MCTSI, and urea levels were associated with higher mortality, whereas CRP, IL-6, NLR, amylase, and lipase showed no association with death. Conclusion LDH is a reliable prognostic marker for severe AP, correlating with severity indices and hospital stays. BISAP, CTSI, and MCTSI effectively predicted disease severity. NLR, LMR, and PLR may assist in monitoring recovery.
背景 急性胰腺炎（AP）是一种严重程度各异的胰腺炎症性疾病。可靠的预后标志物对于早期风险分层至关重要。本研究评估炎症标志物和严重程度指数以预测疾病转归。
目的 这项前瞻性观察性研究旨在评估各种炎症标志物以及急性胰腺炎床边严重程度指数（BISAP）和计算机断层扫描严重程度指数（CTSI）对AP患者的预后价值。
方法 本研究评估了80例AP患者炎症标志物的预后意义。这些标志物包括中性粒细胞与淋巴细胞比值（NLR）、淋巴细胞与单核细胞比值（LMR）、血小板与淋巴细胞比值（PLR）、红细胞分布宽度（RDW）、C反应蛋白（CRP）、白细胞介素-6（IL-6）和乳酸脱氢酶（LDH）。还分析了它们与BISAP、CTSI和改良CTSI的相关性以提高预测准确性。
结果 在研究的80例患者中，酒精是最常见的病因，41例（51%）可见。胆结石是其次的主要病因，19例（24%）患者中发现。参与者年龄在20至80岁之间，平均年龄为40.9±13.9岁。观察到明显的男性 predominance，60例（75%）患者为男性。在本研究中，17例（21%）患者患有轻度胰腺炎，54例（68%）患有中度严重胰腺炎，9例（11%）患有重度胰腺炎。重度病例中LDH显著更高（p<0.0001），LDH水平高于435 U/L预测严重程度的敏感性为100%，特异性为66.8%。NLR、LMR和PLR在恢复期间显著下降（p = 0.001）。较高的LDH、BISAP、CTSI、MCTSI和尿素水平与较高的死亡率相关，而CRP、IL-6、NLR、淀粉酶和脂肪酶与死亡无关联。
结论 LDH是重度AP的可靠预后标志物，与严重程度指数和住院时间相关。BISAP、CTSI和MCTSI有效预测了疾病严重程度。NLR、LMR和PLR可能有助于监测恢复情况。
