重症胰腺炎患者螺旋CT灌注参数与炎症指标及临床症状的关系

  目的  研究重症胰腺炎患者螺旋CT灌注参数与炎症指标C反应蛋白、降钙素原、血清淀粉酶、红细胞积压及临床症状的关系。  方法  回顾性收集2019年1月~2021年1月我院收治的102例胰腺炎患者临床资料，根据Ranson评分将患者分为轻症组(n=64，Ranson评分 < 3分)和重症组(n=38，Ranson评分3~11分)。统计两组炎症指标、临床症状评分及CT关注参数，采用Pearson相关性分析CT灌注参数与炎症指标、临床症状的相关性。  结果  重症组血清C反应蛋白、降钙素原、血清淀粉酶水平及外周血红细胞积压水平、Ranson、急性生理与慢性健康评分(APACHE-Ⅱ)高于轻症组(P < 0.05)，血流量、血流容积低于轻症组(P < 0.05)。Pearson相关性分析结果显示，血流量、血流容积与外周血红细胞积压水平及Ranson、APACHE-Ⅱ评分呈负相关(r=-0.632、-0.673、-0.703和-0.715、-0.662、-0.637，P < 0.05)。  结论  胰腺炎患者病情加重血清C反应蛋白、降钙素原、血清淀粉酶水平及外周血红细胞积压水平，Ranson、APACHE-Ⅱ评分升高，血流量、血流容积降低，重症胰腺炎患者血流量、血流容积与外周血红细胞积压水平、Ranson、APACHE-Ⅱ评分呈显著负相关关系。 

Relationship between spiral CT perfusion parameters and C-reactive protein,procalcitonin, serum amylase,hematocrit and clinical symptoms in patients with severe pancreatitis

  Objective  To explore the relationship between perfusion parameters of spiral CT and C-reactive protein, procalcitonin, serum amylase, hematocrit and clinical symptoms in patients with severe pancreatitis.  Methods  Clinical data of 102 patients with pancreatitis admitted to our hospital from January 2019 to January 2021 were retrospectively collected. The patients were divided into the mild group (n=64, score of Ranson < 3 points) and the severe group (n=38, score of Ranson 3-11 points) according to Ranson score. The inflammatory indicators, score of clinical symptom and CT concern parameters of the two groups were statistically analyzed, and the correlation between CT perfusion parameters and inflammatory indicators and clinical symptoms was analyzed by Pearson correlation.  Results  The levels of serum C-reactive protein, procalcitonin, serum amylase, peripheral blood hematocrit and scores of Ranson, acute physiology and chronic health score (APACHE- II) in the severe group were higher than those in the mild group (P < 0.05), while blood flow, blood flow volume were lower than those in the mild group (P < 0.05). Pearson correlation analysis showed that blood flow and blood flow volume were significantly negatively correlated with level of peripheral blood hematocrit, scores of Ranson and APACHE-II (r=-0.632, -0.673, -0.703 and -0.715, -0.662, -0.637, P < 0.05).  Conclusion  The levels of serum C-reactive protein, procalcitonin and serum amylase, peripheral blood hematocrit, scores of Ranson and APACHE- II are increased, while blood flow and blood flow volume decreased in patients with severe pancreatitis. Blood flow and blood flow volume are significantly negatively correlated with level of peripheral blood hematocrit, scores of Ranson and APACHE-II.