Predictive value of early measurement of serum procalcitonin and C-reactive protein for infectious pancreatic necrosis / 临床肝胆病杂志

ABSTRACT

Objective To investigate the predictive value of early measurement of serum inflammatory mediators for infectious pancreatic necrosis secondary to severe acute pancreatitis (SAP).Methods A retrospective analysis was performed for the clinical data of 166 patients who were admitted to our hospital from January 2012 to January 2017.According to the presence or absence of secondary infectious pancreatic necrosis,the patients were divided into infection group with 58 patients and non-infection group with 108 patients.The serum levels of inflammatory factors were compared between the two groups.The receiver operating characteristic (ROC) curve was used for the analysis of indices with statistical significance.The independent samples t-test was used for comparison of continuous data between groups,and the chi -square test was used for comparison of categorical data between groups.Results Of all 166 SAP patients,58 experienced secondary infectious pancreatic necrosis,resulting in an incidence rate of 34.9％.Compared with the non-infection group,the infection group had significantly higher serum lipase,procalcitonin (PCT),C-reactive protein (CRP),and APACHE Ⅱ score (t =8.679,20.416,18.429,and 8.563,all P ＜0.05).The ROC curve analysis showed that serum lipase,PCT,CRP,and APACHE Ⅱ score had areas under the ROC curve of 0.647,0.877,0.823,and 0.655,respectively,with cut-off values of 612.5 U/L,7.5 ng/ml,226.5 mg/L,and 16.5 points,sensitivities of 68.5％,91.2％,86.8％,and 60.5％,and specificities of 59.3％,83.6％,80.1％,and 68.7％,respectively.Conclusion The abnormally elevated serum levels of CRP and PCT have a certain predictive value for infectious pancreatic necrosis secondary to SAP with convenient and fast operation,and therefore,it holds promise for clinical application.