The predictive value of RDW combined with plasma albumin and blood amylase ratio for infection in acute pancreatitis patients
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摘要: 目的 探究红细胞分布宽度(red blood cell distribution width，RDW)联合血浆白蛋白和血淀粉酶比值对急性胰腺炎(acute pancreatitis，AP)患者合并感染的预测价值。 方法 选取2020年1月—2023年1月新疆维吾尔自治区人民医院诊治的130例AP患者进行回顾性研究，根据感染发生情况分为感染组(35例)和非感染组(95例)。收集入组患者的一般资料、RDW、血浆白蛋白及血淀粉酶比值等临床信息并进行组间分析比较，分别绘制RDW、血浆白蛋白、血淀粉酶比值及联合指标的受试者工作曲线，完成各指标的预测价值评估。 结果 两组基线资料均衡可比；相较于非感染组，感染组患者RDW和血淀粉酶比值显著升高，而血浆白蛋白水平显著降低，差异有统计学意义(P＜0.05)。联合指标预测AP合并感染的预测价值高于RDW、血淀粉酶比和血浆白蛋白单独作为预测指标的价值。 结论 RDW显著升高、血浆白蛋白显著降低和血淀粉酶比值≥0.3可作为预测AP患者合并感染的重要指标，且三项指标联合可提高预测价值，具有较好的临床应用前景。Abstract: Objective To investigate the predictive value of red blood cell distribution width(RDW) combined with the ratio of plasma albumin to serum amylase for infection in acute pancreatitis(AP) patients. Methods A retrospective study was conducted on 130 AP patients who were diagnosed and treated in our hospital from January 2020 to January 2023. The patients were divided into infection group(n=35) and non-infection group(n=95) according to the presence or absence of infection. The general data, RDW, plasma albumin and serum amylase ratio of the enrolled patients were collected and compared between the two groups. The receiver operating characteristic(ROC) curves of RDW, plasma albumin, serum amylase ratio and combined indexes were made respectively, and the predictive value of each index was evaluated. Results The baseline data of the two groups were balanced and comparable. Compared with that of the non-infection group, the ratio of RDW and blood amylase in the infection group was significantly increased, while the plasma albumin level was significantly decreased(P < 0.05). The predictive value of the combined index in predicting AP infection was higher than that of RDW, serum amylase ratio, and plasma albumin alone. Conclusion A significant increase in RDW, a significant decrease in plasma albumin, and serum amylase ratio greater than or equal to 0.3 can be used as important indicators to predict infection in AP patients. The combination of the three indicators can improve the predictive value and has a good clinical application prospect.
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Key words:
- red blood cell distribution width /
- albumin /
- blood amylase /
- acute pancreatitis /
- infection
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表 1 两组患者基线资料比较
项目 感染组(35例) 非感染组(95例) 统计量 P 年龄/岁 45.84±8.74 46.03±11.09 0.040 0.968 性别/例(%) 0.977 0.322 男 20(57.1) 45(47.4) 女 15(42.9) 50(52.6) BMI/(kg/m2) 24.60±2.22 24.57±2.20 0.573 0.568 高血压/例(%) 1.882 0.170 是 11(31.4) 19(20.0) 否 24(68.6) 76(80.0) 糖尿病/例(%) 0.195 0.659 是 14(40.0) 34(35.8) 否 21(60.0) 61(64.2) 高血脂/例(%) 1.813 0.178 是 19(54.3) 39(41.1) 否 16(45.7) 56(58.9) 饮酒史/例(%) 0.112 0.738 是 11(31.4) 27(28.4) 否 24(68.6) 68(71.6) 吸烟史/例(%) 0.195 0.659 是 10(28.6) 31(32.6) 否 25(71.4) 64(67.4) 病因/例(%) 0.835 0.361 胆源性 16(45.7) 52(54.7) 非胆源性 19(54.3) 43(45.3) 胰腺外伤史/例(%) 0.188 0.665 是 9(25.7) 21(22.1) 否 26(74.3) 74(77.9) Ranson评分/分 3.63±1.25 2.99±1.17 1.376 0.171 Marshall评分/分 1.84±1.08 1.66±0.59 1.295 0.198 MCTSI评分/分 5.95±1.38 5.71±1.53 1.096 0.275 
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表 2 两组患者研究指标比较
项目 感染组(35例) 非感染组(95例) 统计量 P RDW 13.58±0.49 13.1±0.32 4.537 ＜0.001 血浆白蛋白/(g/L) 26.85±4.02 30.17±3.70 3.243 0.002 血淀粉酶比值≥0.3/例(%) 13.540 ＜0.001 是 24(68.6) 31(32.6) 否 11(31.4) 64(67.4)
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表 3 独立和联合研究指标的预测价值
预测指标 AUC cut-off值 灵敏度 特异度 RDW 0.736 13.55 0.514 0.926 血浆白蛋白/(g/L) 0.658 29.15 0.657 0.632 血淀粉酶比值≥0.3 0.695 - 0.686 0.705 联合指标 0.834 - 0.800 0.768
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