缺血修饰白蛋白和Ranson评分在急性胰腺炎中的相关性

摘 要] 目的 探讨血浆缺血修饰白蛋白（IMA）水平与Ranson评分在急性胰腺炎（AP）中的相关性。方法采用回顾性研究方法，选取2013年1月至2015年1月期间宝鸡市中心医院收治的161例AP患者，将其分为重症急性胰腺炎（SAP）和轻症急性胰腺炎（MAP）两组。计算并比较两组患者的临床资料、血常规、血生化、IMA、Ranson评分等指标。采用Spearman检验对IMA水平与Ranson评分之间进行相关性分析。结果（1）SAP组BMI、饮酒率、胰淀粉酶水平、IMA水平、Ranson评分均高于MAP组（P < 0.05）；（2）出现腹腔感染18例，假性囊肿11例，术后出血14例，胰腺坏死12例，器官功能衰竭8例，死亡4例。其中胰腺坏死时，IMA为（90.49±17.83） U/mL，Ranson评分为（4.50±2.39），与无胰腺坏死患者相比，两指标均显著升高（P < 0.05）；在死亡患者中，IMA为（101.82±23.49） U/mL，Ranson评分为（6.50±2.38），两指标均高于非死亡患者（P < 0.05）；（3）Spearman相关分析显示，IMA水平与Ranson评分之间呈线性正相关，r=0.846（P < 0.001）。结论 在急性胰腺炎中，IMA与Ranson评分显著相关，IMA对急性胰腺炎严重性和预后具有早期预测价值。

Correlation between ischemia-modifed albumin and Ranson score in patients with acute pancreatitis

Abstractobjective To investigate the correlation between ischemia-modifed albumin (IMA) level and Ranson score in patients with acute pancreatitis (AP). Methods A total of 161 patients defined as AP from Jan. 2013 to Jan. 2015 in Baoji Central Hospital were enrolled and assigned into mild acute pancreatitis (MAP) group and severe acute pancreatitis (SAP) group. Clinical data, blood routine, complete blood count, IMA level, Ranson score were collected and compared between two groups. Spearman correlation was used to evaluate the correlation between IMA level and Ranson score. Results (1) In SAP group, the BMI, drinking rate, pancreatic amylase level, IMA level, Ranson score, were all significantly higher than those in control group (P<0.05); (2)There were 18 abdominal infection, 11 pseudocyst, 14 postoperative bleeding, 12 pancreatic necrosis, 8 organ failure and 4 death. In the cases of pancreatic necrosis, IMA level was (90.49±17.83) U/mL, and the Ranson score was (4.50±2.39), which were significantly higher than those in patients without pancreatic necrosis (P<0.05). For dead patients, IMA level was (101.82±23.49) U/mL, and Ranson score was (6.50±2.38), which were significantly higher than those in patients alive (P<0.05); (3) Spearman correlation analysis showed a linear positive correlation between IMA level and Ranson score (r=0.846, P<0.001). Conclusion For acute pancreatitis patients, IMA is significantly associated with the Ranson score, which will be useful for predicting early severity and prognosis of acute pancreatitis.