平均血小板体积对评估急性胰腺炎病情的价值
|
摘要
目的:探讨平均血小板体积(mean platelet volume,MPV)在急性胰腺炎(acute pancreatitis,AP)病程中的变化情况及其对急性胰腺炎病情的评估价值。方法:回顾性分析214例急性胰腺炎患者的临床资料,根据病情严重程度,将患者分为重症急性胰腺炎组64例、非重症急性胰腺炎组150例,63例健康体检者作为对照组。比较AP组及健康对照组、AP急性期及缓解期MPV,比较重症AP组及非重症AP组MPV、C反应蛋白(CRP)、乳酸脱氢酶(LDH)、Ca~(2+)、白细胞(WBC),绘制受试者工作特征(ROC)曲线比较上述指标对预测重症AP的价值。结果:AP组MPV低于健康对照组(P<0.05);重症AP组MPV低于非重症AP组(P<0.05);AP患者急性期MPV低于缓解期(P<0.05);MPV、CRP、LDH、Ca~(2+)、WBC预测重症急性胰腺炎的ROC曲线下面积(AUC)分别为0.791、0.655、0.708、0.707、0.622。结论:AP患者MPV降低;急性期MPV低于缓解期;重症AP组MPV低于非重症AP组;MPV是评估AP病情的有用的临床指标,预测重症AP的价值高于CRP、WBC、LDH、Ca~(2+)。
Objective: To investigate the changes of mean platelet volume(MPV) in the course of acute pancreatitis(AP) and its value in evaluating the severity of AP. Methods: Retrospectively reviewed the clinical data of 214 patients with acute pancreatitis. According to the severity of the disease, the patients were divided into 64 patients with severe acute pancreatitis,150 patients with non-severe acute pancreatitis. 63 healthy subjects were used as a control group. Compared the MPV levels between AP group and healthy control group. Compare the levels of MPV, CRP, LDH, Ca~(2+) and WBC between severe AP group and non-severe AP group. Compared the levels of MPV in acute phase and remission of acute pancreatitis. The receiver operating characteristic(ROC) curve was used to evaluate the value of MPV, CRP, LDH, Ca~(2+) and WBC in predicting severe acute pancreatitis. Results: Compared with the healthy control group, the MPV levels in the AP group were lower(P<0.05). In the acute phase and the remission period, the MPV levels in the severe AP group were lower than that in the non-severe group(P<0.05). The area under the ROC curve(AUC) of MPV, CRP, LDH, Ca~(2+) and WBC in predicting severe acute pancreatitis were 0.791, 0.655, 0.708, 0.707, 0.622. Conclusion: AP patients have lower MPV and MPV levels in remission period are higher than that in acute phase. In both acute phase and remission, MPV levels in severe AP group are lower than non-severe AP group. Compared with CRP, LDH, Ca~(2+) and WBC, MPV has obvious advantage in predicting severe AP.
Objective: To investigate the changes of mean platelet volume(MPV) in the course of acute pancreatitis(AP) and its value in evaluating the severity of AP. Methods: Retrospectively reviewed the clinical data of 214 patients with acute pancreatitis. According to the severity of the disease, the patients were divided into 64 patients with severe acute pancreatitis,150 patients with non-severe acute pancreatitis. 63 healthy subjects were used as a control group. Compared the MPV levels between AP group and healthy control group. Compare the levels of MPV, CRP, LDH, Ca~(2+) and WBC between severe AP group and non-severe AP group. Compared the levels of MPV in acute phase and remission of acute pancreatitis. The receiver operating characteristic(ROC) curve was used to evaluate the value of MPV, CRP, LDH, Ca~(2+) and WBC in predicting severe acute pancreatitis. Results: Compared with the healthy control group, the MPV levels in the AP group were lower(P<0.05). In the acute phase and the remission period, the MPV levels in the severe AP group were lower than that in the non-severe group(P<0.05). The area under the ROC curve(AUC) of MPV, CRP, LDH, Ca~(2+) and WBC in predicting severe acute pancreatitis were 0.791, 0.655, 0.708, 0.707, 0.622. Conclusion: AP patients have lower MPV and MPV levels in remission period are higher than that in acute phase. In both acute phase and remission, MPV levels in severe AP group are lower than non-severe AP group. Compared with CRP, LDH, Ca~(2+) and WBC, MPV has obvious advantage in predicting severe AP.
引文
1 中华医学会外科学分会胰腺外科学组.急性胰腺炎诊治指南(2014)[J].中华肝胆外科杂志,2015,21(1):1-4.
2 Koutroumpakis E,Slivka A,Furlan A,et al.Management and outcomes of acute pancreatitis patients over the last decade:A US tertiary-center experience[J].Pancreatology,2017,17(1):32-40.
3 阚亮,张萌,何平.高脂血症性急性胰腺炎诊断中检测CRP、PCT临床价值的探讨[J].中国医药导刊,2016,18(3):294-295.
4 Banks PA,Bollen TL,Dervenis C,et al.Classification of acute pancreatitis--2012:revision of the Atlanta classification and definitions by international consensus[J].Gut,2013,62(1):102-111.
5 Balthazar EJ,Robinson DL,Megibow AJ.Acute pancreatitis:value of CT in establishing prognosis [J].Radiology,1990,174(2):331-336.
6 Gasparyan AY,Ayvazyan L,Mikhailidis DP.Mean platelet volume:a link between thrombosis and inflammation?[J].Current Pharmaceutical Design,2011,17(1):47-58.
7 Sansanayudh N,Numthavaj P,Muntham D,et al.Prognostic effect of mean platelet volume in patients with coronary artery disease A systematic review and meta-analysis [J].Thrombosis and Haemostasis,2015,114(6):1299-1309.
8 Bai M,Xing L,Feng J,et al.Mean platelet volume as a possible marker for monitoring the disease activity in ulcerative colitis[J].International Journal of Laboratory Hematology,2016,38(4):e77-e79.
9 Fan Z,Zhang Y,Pan J.Acute Appendicitis and Mean Platelet Volume:A Systemic Review and Meta-analysis[J].Annals of Clinical and Iaboratory Science,2017,47(6):768-772.
10 Sayit AT,Gunbey PH.Is the mean platelet volume in patients with acute cholecystitis an inflammatory marker?[J].Journal of Clinical and Diagnostic Research:JCDR,2015,9(6):5-7.
11 Pan Y,Muheremu A,Wu X.Relationship between platelet parameters and hepatic pathology in patients with chronic hepatitis B infection-a retrospective cohort study of 677 patients[J].The Journal of International Medical Research,2016,44(4):779-786.
12 Okuturlar Y,Soylu A,Dogan H,et al.Mean platelet volume in patients with biliary and non-biliary acute pancreatitis[J].International Journal of Clinical and Experimental Pathology,2015,8(2):2051-2056.
13 Mimidis K,Papadopoulos V,Kotsianidis J,et al.Alterations of platelet function,number and indexes during acute pancreatitis[J].Pancreatology,2004,4(1):22-27.
14 Akbal E,Demirci S,Ko?ak E,et al.Alterations of platelet function and coagulation parameters during acute pancreatitis[J].Blood Coagul Fibrinolysis,2013,24(3):243-246.
15 Papachristou GI .Prediction of severe acute pancreatitis:Current knowledge and novel insights[J].World Journal of Gastroenterology,2008,14(41):6273-6275.
16 Yüksel O,Helvaci K,Ba?ar O,et al.An overlooked indicator of disease activity in ulcerative colitis:mean platelet volume[J].Platelets,2009,20(4):277-281.
17 Mayer J,Rau B,Gansauge F,et al.Inflammatory mediators in human acute pancreatitis:clinical and pathophysiological implications[J].Gut,2000,47(4):546- 552.
18 Beyazit Y,Sayilir A,Torun S,et al.Mean platelet volume as an indicator of disease severity in patients with acute pancreatitis[J].Clinics and Research in Hepatology and Gastroenterology,2012,36(2):162-168.
19 Erbis H,Aliosmanoglu I,Turkoglu MA,et al.Evaluating mean platelet volume as a new indicator for confirming the diagnosis of necrotizing pancreatitis[J].Annali Italiani Di Chirurgia,2015,86(2):132-136.
20 Lei JJ,Zhou L,Liu Q,et al.Can mean platelet volume play a role in evaluating the severity of acute pancreatitis?[J].World Journal of Gastroenterology,2017,23(13):2404-2413.
21 Khanna AK ,Meher S,Prakash S,et al.Comparison of ranson,glasgow,MOSS,SIRS,BISAP,APACHE-II,CTSI Scores,IL-6,CRP,and procalcitonin in predicting severity,organ failure,pancreatic necrosis,and mortality in acute pancreatitis[J].HPB Surgery,2013,2013:1-10.
22 Chen CC,Wang SS,Chao Y,et al.C-reactive protein and lactate dehydrogenase isoenzymes in the assessment of the prognosis of acute pancreatitis[J].Journal of Gastroenterology and Hepatology,1992,7(4):363-366.
23 Cui J,Xiong J,Zhang Y,et al.Serum lactate dehydrogenase is predictive of persistent organ failure in acute pancreatitis[J].J Crit Care,2017,41:161-165.
24 Tasic T,Grgov S,Nagorni A,et al.Comparison of biohumoral and morphological parameters in acute pancreatitis[J].Srpski Arhiv Za Celokupno Lekarstvo,2014,142(1-2):29.
25 Zrnic IK,Milic S,Fisic E,et al.C-reactive protein and lactate dehydrogenase as single prognostic factors of severity in acute pancreatitis[J].Lijec nic ki Vjesnik,2007,129(1-2):1.
2 Koutroumpakis E,Slivka A,Furlan A,et al.Management and outcomes of acute pancreatitis patients over the last decade:A US tertiary-center experience[J].Pancreatology,2017,17(1):32-40.
3 阚亮,张萌,何平.高脂血症性急性胰腺炎诊断中检测CRP、PCT临床价值的探讨[J].中国医药导刊,2016,18(3):294-295.
4 Banks PA,Bollen TL,Dervenis C,et al.Classification of acute pancreatitis--2012:revision of the Atlanta classification and definitions by international consensus[J].Gut,2013,62(1):102-111.
5 Balthazar EJ,Robinson DL,Megibow AJ.Acute pancreatitis:value of CT in establishing prognosis [J].Radiology,1990,174(2):331-336.
6 Gasparyan AY,Ayvazyan L,Mikhailidis DP.Mean platelet volume:a link between thrombosis and inflammation?[J].Current Pharmaceutical Design,2011,17(1):47-58.
7 Sansanayudh N,Numthavaj P,Muntham D,et al.Prognostic effect of mean platelet volume in patients with coronary artery disease A systematic review and meta-analysis [J].Thrombosis and Haemostasis,2015,114(6):1299-1309.
8 Bai M,Xing L,Feng J,et al.Mean platelet volume as a possible marker for monitoring the disease activity in ulcerative colitis[J].International Journal of Laboratory Hematology,2016,38(4):e77-e79.
9 Fan Z,Zhang Y,Pan J.Acute Appendicitis and Mean Platelet Volume:A Systemic Review and Meta-analysis[J].Annals of Clinical and Iaboratory Science,2017,47(6):768-772.
10 Sayit AT,Gunbey PH.Is the mean platelet volume in patients with acute cholecystitis an inflammatory marker?[J].Journal of Clinical and Diagnostic Research:JCDR,2015,9(6):5-7.
11 Pan Y,Muheremu A,Wu X.Relationship between platelet parameters and hepatic pathology in patients with chronic hepatitis B infection-a retrospective cohort study of 677 patients[J].The Journal of International Medical Research,2016,44(4):779-786.
12 Okuturlar Y,Soylu A,Dogan H,et al.Mean platelet volume in patients with biliary and non-biliary acute pancreatitis[J].International Journal of Clinical and Experimental Pathology,2015,8(2):2051-2056.
13 Mimidis K,Papadopoulos V,Kotsianidis J,et al.Alterations of platelet function,number and indexes during acute pancreatitis[J].Pancreatology,2004,4(1):22-27.
14 Akbal E,Demirci S,Ko?ak E,et al.Alterations of platelet function and coagulation parameters during acute pancreatitis[J].Blood Coagul Fibrinolysis,2013,24(3):243-246.
15 Papachristou GI .Prediction of severe acute pancreatitis:Current knowledge and novel insights[J].World Journal of Gastroenterology,2008,14(41):6273-6275.
16 Yüksel O,Helvaci K,Ba?ar O,et al.An overlooked indicator of disease activity in ulcerative colitis:mean platelet volume[J].Platelets,2009,20(4):277-281.
17 Mayer J,Rau B,Gansauge F,et al.Inflammatory mediators in human acute pancreatitis:clinical and pathophysiological implications[J].Gut,2000,47(4):546- 552.
18 Beyazit Y,Sayilir A,Torun S,et al.Mean platelet volume as an indicator of disease severity in patients with acute pancreatitis[J].Clinics and Research in Hepatology and Gastroenterology,2012,36(2):162-168.
19 Erbis H,Aliosmanoglu I,Turkoglu MA,et al.Evaluating mean platelet volume as a new indicator for confirming the diagnosis of necrotizing pancreatitis[J].Annali Italiani Di Chirurgia,2015,86(2):132-136.
20 Lei JJ,Zhou L,Liu Q,et al.Can mean platelet volume play a role in evaluating the severity of acute pancreatitis?[J].World Journal of Gastroenterology,2017,23(13):2404-2413.
21 Khanna AK ,Meher S,Prakash S,et al.Comparison of ranson,glasgow,MOSS,SIRS,BISAP,APACHE-II,CTSI Scores,IL-6,CRP,and procalcitonin in predicting severity,organ failure,pancreatic necrosis,and mortality in acute pancreatitis[J].HPB Surgery,2013,2013:1-10.
22 Chen CC,Wang SS,Chao Y,et al.C-reactive protein and lactate dehydrogenase isoenzymes in the assessment of the prognosis of acute pancreatitis[J].Journal of Gastroenterology and Hepatology,1992,7(4):363-366.
23 Cui J,Xiong J,Zhang Y,et al.Serum lactate dehydrogenase is predictive of persistent organ failure in acute pancreatitis[J].J Crit Care,2017,41:161-165.
24 Tasic T,Grgov S,Nagorni A,et al.Comparison of biohumoral and morphological parameters in acute pancreatitis[J].Srpski Arhiv Za Celokupno Lekarstvo,2014,142(1-2):29.
25 Zrnic IK,Milic S,Fisic E,et al.C-reactive protein and lactate dehydrogenase as single prognostic factors of severity in acute pancreatitis[J].Lijec nic ki Vjesnik,2007,129(1-2):1.