Predictive value of combined measurement of D-dimer, fibrinogen, and peripheral blood leukocyte count for severity of acute pancreatitis / 临床肝胆病杂志

ABSTRACT

Objective To explore the predictive value of combined measurement of D-dimer (D-D),fibrinogen (FIB),and peripheral blood leukocyte count (PBLC) for the severity of acute pancreatitis (AP).Methods We collected the clinical data of 134 hospitalized patients who were diagnosed with AP in the General Hospital of Ningxia Medical University from January 2014 to January 2016.These patients were divided into mild acute pancreatitis (MAP) group (n =72) and severe acute pancreatitis (SAP) group (n =62).Also,these patients were divided into hyperlipidemic acute pancreatitis (HAP) group (n =43) and biliogenic acute pancreatitis (BAP) group (n =91).The initial measurements of D-D,FIB,and PBLC for the patients who were admitted to the hospital within 24 hours of onset and received no treatment before admission were collected.The t test was used for comparison of normally distributed continuous data,while the Mann-Whitney U test was used for non-normally distributed continuous data.The chi-square test was used for comparison of categorical data.In addition,the Spearman correlation test and Pearson correlation test were used for correlation analyses.The receiver operating characteristic (ROC) curve was used to analyze the predictive values of D-D,FIB,and PBLC for the severity of AP.Results Compared with the MAP group,the SAP group had significantly increased D-D and FIB levels in peripheral blood (Z =-3.171,P =0.002;t =-2.339,P =0.021).Compared with the HAP group,the BAP group had a significantly higher D-D level (Z =-4.178,P ＜ 0.001),an insignificantly higher FIB level (P ＞ 0.05),and a significantly lower PBLC (t =2.466,P =0.015).The areas under the ROC curve (AUCs) of D-D,FIB,and PBLC were 0.659,0.611,and 0.591,respectively,and D-D had a higher value than FIB and PBLC in predicting the severity of SAP.The AUC of a combination of D-D,FIB,and PBLC was 0.712.Plasma D-D and FIB levels were positively correlated with the severity of AP (r =0.275 and 0.192,P =0.001 and 0.026).Conclusions D-D,FIB,and PBLC are important for early judgment of the severity of AP,and a combination of the three markers has greater significance.