网织红细胞参数在急性胰腺炎中的临床意义

目的探讨急性胰腺炎(AP)患者外周血网织红细胞(RET)参数水平变化及临床意义。方法选取淄博市临淄区人民医院86例AP患者作为研究对象(AP组),其中轻症51例(轻症组),重症35例(重症组,其中住院期间死亡7例);另选取50名同期健康体检者作为对照组。分别抽取AP组入院第1、5、10天和对照组体检时外周静脉血,检测RET、网织红细胞比率(RET%)、未成熟网织红细胞比率(IRF)、低荧光强度网织红细胞(LFR)、中荧光强度网织红细胞(MFR)、高荧光强度网织红细胞(HFR)水平。采用受试者工作特征(ROC)曲线分析IRF、LFR、HFR单独及联合检测早期诊断AP的价值。结果 AP组入院第1、5、10天血液RET、RET%、IRF、MFR、HFR均高于对照组,LFR低于对照组,且重症组LFR低于轻症组,其他参数均高于轻症组;轻症组及重症组患者第5、10天RET、RET%、IRF、HFR高于第1天,LFR低于第1天;轻症组及重症组患者入院第10天RET、RET%、IRF、MFR、HFR较入院第5天有所下降,LFR有所升高(P<0.05)。ROC曲线分析结果显示,血液IRF、LFR、HFR联合检测早期诊断AP的曲线下面积(AUC)为0.922,敏感性为86%,特异性为92%,均高于单独检测。结论 AP患者外周血RET参数水平变化可反映疾病严重程度,IRF、LFR、HFR联合检测可能是早期诊断AP的有效指标。

Clinical significance of reticulocyte parameters in acute pancreatitis

Objective To investigate the levels of reticulocyte(RET)parameters in peripheral blood of acute pancreatitis(AP)patients and its clinical significance.Methods A total of 86 hospitalized AP patients,including 51 mild cases and 35 severe cases(7 deaths during hospitalization),and 50 healthy individuals(control group)who underwent physical examination were enrolled in this study.Peripheral venous blood was collected in AP patients on day 1,5 and 10 of admission and in healthy individuals during physical examination.The levels of RET parameters including reticulocyte(RET),reticulocyte percentage(RET%),immature reticulocyte fraction(IRF),low fluorescence reticulocyte(LFR),medium fluorescence reticulocyte(MFR)and high fluorescence reticulocyte(HFR)were detected.The receiver operating characteristics(ROC)curves were used to analyze the diagnostic value of IRF,LFR and HFR for AP.Results The levels of RET,RET%,IRF,MFR and HFR in AP group on day 1,5 and 10 of admission were higher than those in the control group,while LFR level was on the contrary.In mild and severe AP patients,RET,RET%,IRF and HFR on day 5 and 10 were higher than those on day 1,while LFR level was lower than that on day 1.On the 10th day of admission,except for the increased LFR,the levels of other parameters in mild and severe patients were decreased compared with those on day 5 of admission(P<0.05).ROC curve analysis showed that the area under curve(AUC)of the combined detection of IRF,LFR and HFR was 0.922 with sensitivity of 86%and specificity of 92%,which were higher than single detection.Conclusion The levels of RET parameters can reflect the severity of AP.Combined detection of IRF,LFR and HFR may be an effective diagnostic marker for early AP.