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ISSN 1001-5256 (Print)
ISSN 2097-3497 (Online)
CN 22-1108/R
Issue 8
Aug.  2017
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Article Contents

Predictive value of combined measurement of D-dimer, fibrinogen, and peripheral blood leukocyte count for severity of acute pancreatitis

DOI: 10.3969/j.issn.1001-5256.2017.08.023
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  • Received Date: 2017-01-23
  • Published Date: 2017-08-20
  • 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.

     

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  • [1]Pancreas Study Group, Chinese Society of Gastroenterology, Chinese Medical Association, Editorial Board of Chinese Journal of Pancreatology, Editorial Board of Chinese Journal of Digestion.Chinese guidelines for the management of acute pancreatitis (Shanghai, 2013) [J].J Clin Hepatol, 2013, 29 (9) :656-660. (in Chinese) 中华医学会消化病学分会胰腺疾病学组, 《中华胰腺病杂志》编辑委员会, 《中华消化杂志》编辑委员会.中国急性胰腺炎诊治指南 (2013, 上海) [J].临床肝胆病杂志, 2013, 29 (9) :656-660.
    [2]Chinese College of Emergency Physicians.Chinese clinical practice guidelines for emergency treatment of acute pancreatitis in 2013[J].Chin J Crit Care Med, 2013, 33 (12) :1057-1071. (in Chinese) 中国医师协会急诊医师分会.2013中国急诊急性胰腺炎临床实践指南[J].中国急救医学, 2013, 33 (12) :1057-1071.
    [3]POPA CC, BADIU DC, RUSU OC, et al.Mortality prognostic factors in acute pancreatitis[J].J Med Life, 2016, 9 (4) :413-418.
    [4]CHEN YH.Study on the correlation between early coagulation index and severity of acute pancreatitis[D].Nanjing:Nanjing Univ, 2014. (in Chinese) 陈玉辉.急性胰腺炎早期凝血指标与病情严重度的相关性研究[D].南京:南京大学, 2014.
    [5]WROBLESKI DM, BARTH MM, OYEN LJ.Necrotizing pancreatitis:pathophysiology, diagnosis, and acute care management[J].AACN Clin Issues, 1999, 10 (4) :464-477.
    [6]ZENG H, LIN XH, WANG HY.Combination detection of fibrinogen and D-dimmer for early diagnosis of severe acute pancreatitis[J].Acad J Guangzhou Med Coll, 2007, 35 (1) :49-50. (in Chinese) 曾华, 林向华, 王惠英.纤维蛋白原和D-二聚体联合检测在重症急性胰腺炎早期诊断中的作用[J].广州医学院学报, 2007, 35 (1) :49-50.
    [7]WERNER J, RIVERRA J, FERNANDEZ-DEL CASTILLO C, et al.Differing roles of nitric oxide in the pathogenesis of acute edematous versus necrotizing pancreatitis[J].Surgery, 1997, 121 (1) :23-30.
    [8]QIAN JM, LAI YM.Clinical advances in acute pancreatitis[J].JClin Hepatol, 2013, 29 (7) :481-483. (in Chinese) 钱家鸣, 赖雅敏.急性胰腺炎分型与病情评估的研究进展[J].临床肝胆病杂志, 2013, 29 (7) :481-483.
    [9]SALOMONE T, TOSI P, PALARETI G, et al.Coagulative disorders in human acute pancreatitis:role for the D-dimer[J].Pancreas, 2003, 26 (2) :111-116.
    [10]RADENKOVIC D, BAJEC D, IVANCEVIC N, et al.D-dimer in acute pancreatitis:a new approach for an early assessment of organ failure[J].Pancreas, 2009, 38 (6) :655-660.
    [11]KONG H, DING Z, ZHU XC, et al.D-Dimer change in human acute pancreatitis as determined by serumal triglyceride[J].Pancreas, 2011, 40 (7) :1103-1106.
    [12]WU HJ, LI RX, LI Y, et al.Plasma D-dimer changes and prognostic implication in severe acute pancreatitis[J].Chin Critical Care Med, 2012, 24 (11) :658-661. (in Chinese) 吴红军, 李荣霞, 李毅, 等.重症急性胰腺炎血浆D-二聚体变化的临床研究[J].中国危重病急救医学, 2012, 24 (11) :658-661.
    [13]YU XE.Predictive value of neutrophils-lymphocytes ratio in the severity of acute pancreatitis[J].Chin J Gastroenterol Hepatol, 2012, 21 (6) :574-577. (in Chinese) 余贤恩.中性粒细胞与淋巴细胞比值对急性胰腺炎严重性的预测价值[J].胃肠病学和肝病学杂志, 2012, 21 (6) :574-577.
    [14]DENG HB, ZHU T, ZHOU DY.Value of D-dimer to the prognosis of severe acute pancreatitis[J].Clin Educ Gen Pract, 2015, 13 (6) :626-628. (in Chinese) 邓会标, 朱涛, 周道扬.D-二聚体对重症急性胰腺炎预后预测的价值[J].全科医学临床与教育, 2015, 13 (6) :626-628.
    [15]KE L, NI HB, TONG ZH, et al.D-dimer as a marker of severity in patients with severe acute pancreatitis[J].J Hepatobiliary Pancreat Sci, 2012, 19 (3) :259-265.
    [16]ZHANG DL, HAO JY, YANG N.Changes of D-dimer, coagulation indices and relation with calcium in patients with hyperlipidemic acute pancreatitis[J].Chin Med Rec, 2015, 16 (10) :91-93. (in Chinese) 张冬磊, 郝建宇, 杨宁.高脂血症性急性胰腺炎患者D-二聚体和凝血指标的变化及其与血钙的关系[J].中国病案, 2015, 16 (10) :91-93.
    [17]CAO WG, LI X, QU HY.Hyperlipidemic acute pancreatitis:a clinical analysis of 10 cases[J/CD].Chin J Exp Clin Infect Dis:Electronic Edition, 2015, 9 (3) :416-417. (in Chinese) 曹卫刚, 李霞, 曲恒怡.高脂血症性急性胰腺炎10例的临床分析[J/CD].中华实验和临床感染病杂志:电子版, 2015, 9 (3) :416-417.
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