实用临床医药杂志2024，Vol.28Issue(17)：62-67,6.DOI:10.7619/jcmp.20240043
急性生理学与慢性健康状况评分系统Ⅱ评分联合血清糖化血红蛋白、乳酸脱氢酶水平评估急性胰腺炎患者病情严重程度及预后的价值
Values of the Acute Physiology and Chronic Health Evaluation Ⅱ score combined with serum glycated hemoglobin and lactate dehydrogenase in evaluating the severity and prognosis of patients with acute pancreatitis
摘要
Abstract
Objective To investigate the values of the Acute Physiology and Chronic Health E-valuation Ⅱ(APACHE Ⅱ)score,serum glycated hemoglobin(HbA1c)and lactate dehydrogenase(LDH)in evaluating the severity and prognosis of patients with acute pancreatitis(AP).Methods A total of 120 patients with AP treated in the hospital from August 2019 to May 2022 were divided into mild group(n=33),moderately severe group(n=52),and severe group(n=35)according to the severity of the disease,and were also divided into survival group(n=86)and death group(n=34)based on prognosis.Pearson method was used to analyze the correlations of APACHE Ⅱ score with serum HbA1c and LDH levels in patients with AP;the Logistic regression analysis was used to deter-mine the influencing factors of prognosis in patients with AP;the receiver operating characteristic(ROC)curve was used to evaluate the predictive values of APACHE Ⅱ score,HbA1c and LDH for the prognosis of AP.Results The levels of serum triglycerides,HbA1c,LDH,APACHE Ⅱ score,and the Modified CT Severity Index(MCTSI)score gradually increased while high-densitylipopro-tein cholesterol,low-density lipoprotein cholesterol,and serum calcium gradually decreased in the mild,moderately severe,and severe groups(P＜0.05).APACHE Ⅱ score and MCTSI score were positively correlated with serum HbA1c and LDH levels in patients with AP(P＜0.05).Triglycer-ides,high-density lipoprotein cholesterol,low-density lipoprotein cholesterol,serum calcium,MCTSI score,HbA1c,LDH,and APACHE Ⅱ score were factors influencing poor prognosis in pa-tients with AP(P＜0.05).The area under the curve for predicting poor prognosis in patients with AP by the combination of APACHE Ⅱ score,serum HbA1c and LDH levels was 0.930,with a sen-sitivity of 91.18％and a specificity of 83.72％,which was superior to each factor alone(Zcombined-HbA1c=3.511,Zcombined-LDH=4.798,Zcombined-APACHE U score=2.134,P＜0.001,P＜0.001,P=0.033).Conclusion Serum HbA1c and LDH levels are closely related to the severity of the disease,and their combination with APACHE Ⅱ score has good predictive value for the prognosis of patients with AP.关键词
急性胰腺炎/急性生理学与慢性健康状况评分系统Ⅱ/糖化血红蛋白/乳酸脱氢酶Key words
acute pancreatitis/the Acute Physiology and Chronic Health Evaluation Ⅱ/gly-cated hemoglobin/lactate dehydrogenase分类
医药卫生引用本文复制引用
张臣臣,刘艳玲..急性生理学与慢性健康状况评分系统Ⅱ评分联合血清糖化血红蛋白、乳酸脱氢酶水平评估急性胰腺炎患者病情严重程度及预后的价值[J].实用临床医药杂志,2024,28(17):62-67,6.基金项目
湖北省荆门市科技计划项目(2018YDKY020) （2018YDKY020）
