Baillargeon J D, Orav J, Ramagopal V, Tenner S M, Banks P A
Center for Pancreatic Disease, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts 02115, USA.
Am J Gastroenterol. 1998 Nov;93(11):2130-4. doi: 10.1111/j.1572-0241.1998.00608.x.
The aim of our study was to determine whether measurement of serum hematocrit during the first 24 h helps in distinguishing necrotizing from mild pancreatitis.
From May 1992 to June 1996, a case-control study was performed with cases of patients with necrotizing pancreatitis. We selected as a control the next patient admitted with mild pancreatitis.
There were 32 patients in each group. Logistic regression identified an admission hematocrit of > or = 47% and a failure of admission hematocrit to decrease at 24 h as the best binary risk factors for necrotizing pancreatitis. At admission, more patients with necrotizing pancreatitis than with mild pancreatitis had a hematocrit > or = 47% (11/32 vs 3/32; p = 0.03). At 24 h, 15 additional patients with necrotizing pancreatitis versus only one with mild pancreatitis showed no decrease in admission hematocrit (p < 0.01). Thus, by 24 h, 26 of 32 patients with necrotizing pancreatitis versus only four of 32 patients with mild pancreatitis met one or the other criterion (p < 0.01). The sensitivity and specificity at admission were 34% and 91%; at 24 h, 81% and 88%.
Hemoconcentration with an admission hematocrit > or = 47% or failure of admission hematocrit to decrease at approximately 24 h were strong risk factors for the development of pancreatic necrosis.
我们研究的目的是确定在最初24小时内测量血清血细胞比容是否有助于区分坏死性胰腺炎和轻度胰腺炎。
从1992年5月至1996年6月，对坏死性胰腺炎患者进行了病例对照研究。我们选择下一位入院的轻度胰腺炎患者作为对照。
每组有32例患者。逻辑回归分析确定入院时血细胞比容≥47%以及入院时血细胞比容在24小时内未降低是坏死性胰腺炎的最佳二元风险因素。入院时，坏死性胰腺炎患者中血细胞比容≥47%的患者比轻度胰腺炎患者更多（11/32对3/32；p = 0.03）。在24小时时，另外15例坏死性胰腺炎患者与仅1例轻度胰腺炎患者的入院血细胞比容未降低（p < 0.01）。因此，到24小时时，32例坏死性胰腺炎患者中有26例与32例轻度胰腺炎患者中仅4例符合一项或另一项标准（p < 0.01）。入院时的敏感性和特异性分别为34%和91%；在24小时时，分别为81%和88%。
入院时血细胞比容≥47%导致的血液浓缩或入院时血细胞比容在约24小时内未降低是胰腺坏死发生的强烈风险因素。
