肝素结合蛋白联合降钙素原在评估急性胰腺炎合并感染中的预测价值

目的 急性胰腺炎合并感染是临床上棘手的问题,探讨肝素结合蛋白(heparin-binding protein,HBP)及降钙素原(procalcitonin,PCT)在预测急性胰腺炎合并感染中的价值。 方法 收集2018年12月—2019年12月在蚌埠医学院第一附属医院急诊外科诊治的急性胰腺炎患者共64例,根据是否合并胰周感染,分为单纯急性胰腺炎组和急性胰腺炎合并感染组各32例,分别于诊断时当天(D1)及治疗后第7天(D7)测定患者HBP及PCT的血浆浓度,对急性胰腺炎合并感染组的患者积极干预治疗,比较2组HBP及PCT的水平差异,并使用受试者工作特征(ROC)曲线分析计算其的临界值、特异度和敏感度。 结果 单纯急性胰腺炎组和急性胰腺炎合并感染组中HBP水平D1:(61.97±34.84)ng/mL vs.(130.12±45.76)ng/mL,D7:(8.60±2.91)ng/mL vs.(10.08±3.16)ng/mL]、PCT水平D1:(1.82±0.65)ng/mL vs.(4.48±2.58)ng/mL,D7:(0.50±0.21)ng/mL vs.(0.64±0.37)ng/mL]差异均有统计学意义(均P<0.05)。HBP的ROC曲线下面积为0.895,敏感度为90.60%,特异度为78.10%;PCT的ROC曲线下面积为0.899,敏感度为81.30%,特异度为96.90%;HBP联合PCT的ROC曲线下面积为0.981,敏感度为96.90%,特异度为65.60%。 结论 HBP和PCT可分别作为预测急性胰腺炎合并感染的指标,联合检测可明显提高敏感性,有利于早期发现并治疗急性胰腺炎合并感染患者。 

Predictive value of heparin-binding protein combined with procalcitonin in the assessment of acute pancreatitis co-infection

Objective To explore the application value of dynamic changes of heparin-binding protein and procalcitonin in predicting acute pancreatitis co-infection. Methods A total of 64 patients with acute pancreatitis diagnosed and treated in the Emergency Department of the First Affiliated Hospital of Bengbu Medical College from December 2018 to December 2019 were collected. They were divided into simple acute pancreatitis group and acute pancreatitis co-infection group according to whether the patients were infected with peripancreatic infection during hospitalization, 32 patients in each group. The plasma concentrations of heparin-binding protein(HBP) and procalcitonin(PCT) on the day of diagnosis(D1) and the day 7(D7) after treatment were measured. Actively intervened and treatment were preformed in the acute pancreatitis co-infection group. The t test was used to compare the differences in HBP and PCT levels between the two groups. The receiver operating characteristic(ROC) curve analysis was used to calculate their threshold value, specificity and sensitivity. Results HBP levels in the simple acute pancreatitis group and the acute pancreatitis co-infection group group were as follows: D1 (61.97±34.84) ng/mL vs.(130.12±45.76) ng/mL] and D7 (8.60±2.91) ng/mL vs.(10.08±3.16) ng/mL, all P<0.05]. The PCT level were as follows: D1 (1.82±0.65) ng/mL vs.(4.48±2.58) ng/mL] and D7 (0.50±0.21) ng/mL vs.(0.64±0.37) ng/mL, all P<0.05]. The area under the ROC curve of HBP was 0.895, sensitivity 90.60%, specificity 78.10%; the area under the ROC curve of PCT was 0.899, sensitivity 81.30%, specificity 96.90%; and the area under ROC curve of HBP combined with PCT was 0.981, the sensitivity was 96.90%, the specificity was 65.60%. Conclusion HBP and PCT can be used as indicators to predict the infection of acute pancreatitis, and combined detection can significantly improve the sensitivity, which is conducive to early detection and treatment of patients with pancreatitis co-infection.