C-反应蛋白评估老年高脂血症急性胰腺炎严重程度的意义

发布时间：2018-10-24 10:34

【摘要】：目的研究C反应蛋白(CRP)在评估老年高脂血症急性胰腺炎(HLAP)疾病严重程度的意义。方法选择2012年1月至2014年7月在该院接受治疗的急性胰腺炎(AP)老年患者178例。其中HLAP患者59例为观察组,余下119例未非高脂血症急性胰腺炎(NHLAP)患者,为对照组。对比两组临床特征、不同时间段的CRP水平,然后根据CRP最佳阀值对不同严重程度的AP患者进行诊断。最后采用logistics回归分析对影响CRP水平的因素进行分析。结果观察组伴有糖尿病、脂肪肝、AP复发率及重度AP(SAP)比例均显著大于对照组;对比两组CRP水平发现1~3 d呈上升状态,直到第4天开始下降,并且第2~4天观察组CRP水平显著高于对照组;在确定CRP诊断最佳阀值后对两组严重程度诊断发现观察组的准确度、灵敏度及特异性均显著高于对照组(均P0.05)。最后对可能影响CRP水平因素进行Logistic回归性分析筛选出4个影响因素,即脂肪肝、糖尿病、高密度脂肪酸(HDL)以及极低密度脂肪酸(VLDL)。结论 (1)HLAP病患伴有糖尿病、脂肪肝等疾病的可能性更大,并且病情相对更为严重。(2)利用CRP作为诊断标准对AP病患进行严重程度分级准确度较高,其中在HLAP病患中更高。(3)糖尿病、脂肪肝、HDL以及VLDL是CRP升高的影响因素,在临床诊断中应引起重视。
[Abstract]:Objective to study the significance of C reactive protein (CRP) (CRP (CRP) in evaluating the severity of (HLAP) in elderly patients with acute pancreatitis with hyperlipidemia. Methods 178 elderly patients with acute pancreatitis (AP) who were treated in our hospital from January 2012 to July 2014 were selected. 59 cases of HLAP were observed group, and the remaining 119 cases of (NHLAP) without non hyperlipidemia were as control group. The clinical features of the two groups were compared and the CRP levels at different time periods were compared. Then the patients with different severity of AP were diagnosed according to the optimal threshold of CRP. Finally, the factors influencing CRP level were analyzed by logistics regression analysis. Results the incidence of diabetes, fatty liver, recurrence rate of AP and the proportion of severe AP (SAP) in the observation group were significantly higher than those in the control group. The level of CRP in the observation group was significantly higher than that in the control group on the second day of 4 days, and the accuracy, sensitivity and specificity of the observation group were significantly higher than those of the control group after determining the best threshold for the diagnosis of CRP (P0.05). Finally, four factors, fatty liver, diabetes, high density fatty acid (HDL) and very low density fatty acid (VLDL)., were selected by Logistic regression analysis. Conclusion (1) HLAP patients are more likely to be associated with diabetes, fatty liver and other diseases, and the disease is relatively more serious. (2) CRP is used as diagnostic criterion to grade the severity of AP patients with higher accuracy, especially in HLAP patients. (3) Diabetes mellitus. Fatty liver, HDL and VLDL are the influencing factors of the increase of CRP, which should be paid more attention to in clinical diagnosis.
【作者单位】：浙江大学医学院附属第二医院普外科;宁波市镇海龙赛医院普外科;
【分类号】：R589.2;R576

【参考文献】