Prognostic evaluation of pancreatic CT density and maximum cross-sectional area combined with NLR detection in severe pancreatitis
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摘要:
目的 探讨胰腺CT密度和最大截面积联合中性粒细胞淋巴细胞比值（NLR）检测在重症胰腺炎预后的评估价值。 方法 选取2020年6月~2022年1月我院收治的46例重症胰腺炎患者作为观察组，另选同期40例健康体测者作为对照组，对所有研究对象进行CT检查，结合Image J计算胰腺CT密度和最大截面积，检测NLR，利用ROC曲线分析三者联合对重症胰腺炎预后评估的价值。 结果 观察组患者胰腺CT密度小于对照组（P < 0.05），最大截面积大于对照组（P < 0.05）；观察组患者NLR高于对照组（P < 0.05），BISAP评分较高；CT密度和最大截面积评估重症胰腺炎预后的曲线下面积为0.786，敏感度为80.31%，特异性为80.84%；NLR评估重症胰腺炎预后的曲线下面积为0.775，敏感度为62.51%，特异性为56.27%；CT密度及最大截面积联合NLR评估重症胰腺炎预后的曲线下面积为0.884，敏感度为87.51%，特异性为82.15%。 结论 利用胰腺CT密度和最大截面积联合NLR检测对重症胰腺炎预后进行评估具有一定的临床应用价值。 -
关键词:
- CT密度 /
- 最大截面积 /
- 中性粒细胞淋巴细胞比值检测 /
- 重症胰腺炎 /
- 预后
Abstract:Objective To investigate the prognostic value of pancreatic CT density and maximum cross-sectional area combined with neutrophil lymphocyte ratio (NLR) detection in severe pancreatitis. Methods Forty-six patients with severe pancreatitis who admitted to our hospital from November 2019 to November 2021 were selected, and 40 healthy subjects were selected as the control group during the same period. CT examination was performed on all subjects, combined with Image J to calculate the CT density and maximum cross-sectional area of the pancreas, and NLR was detected. Results The CT density of the pancreas in the observation group was significantly lower than that in the control group (P < 0.05). The maximum cross-sectional area was significantly larger than that in the control group (P < 0.05). The NLR in the observation group was significantly higher than that in the control group (P < 0.05), and the score was higher. The area under the curve of CT density and maximum cross-sectional area for evaluating the prognosis of severe pancreatitis was 0.786, the sensitivity was 80.31%, and the specificity was 80.84%. The area under the curve of NLR for evaluating the prognosis of severe pancreatitis was 0.775, and the sensitivity was 62.51%, specificity was 56.27%. The area under the curve of CT density and maximum cross-sectional area combined with NLR to evaluate the prognosis of severe pancreatitis was 0.884, the sensitivity was 87.51%, and the specificity was 82.15%. Conclusion The use of pancreatic CT density and maximum cross-sectional area combined with NLR detection has a certain clinical value in evaluating the prognosis of severe pancreatitis. -
图 2 胰腺CT密度和最大截面积联合NLR评估重症胰腺炎预后的ROC曲线
Figure 2. ROC curve of pancreatic CT density and maximum cross-sectional area combined with NLR in evaluating the prognosis of severe pancreatitis.
表 1 两组患者胰腺CT密度及最大截面积比较
Table 1. Comparison of CT density and maximum cross- sectional area of pancreas between the two groups (Mean±SD)
组別 CT密度(unit) 最大截面积(unit) 观察组(n=46) 105.27±10.63 4627.25±532.84 对照组(n=40) 122.05±15.34 1352.33±367.19 t 5.957 32.692 P < 0.001 < 0.001 
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表 2 两组患者NLR及BISAP评分比较
Table 2. Comparison of NLR and bisap scores between the two groups (Mean±SD)
组別 NLR BISAP评分(分） 观察组(n=46) 5.36±1.50 3.65±0.64 对照组(n=40) 1.68±0.57 - t 14.617 P < 0.001 NLR: 中性粒细胞淋巴细胞比值.
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表 3 胰腺CT密度和最大截面积联合NLR评估重症胰腺炎预后的价值
Table 3. Value of pancreatic CT density and maximum cross-sectional area combined with NLR in evaluating the prognosis of severe pancreatitis
变量 SE AUC(95%CI) P 敏感度(%) 特异度(%) CT密度+最大截面积 0.0316 0.786 0.007 80.31 80.84 NLR 0.0405 0.775 0.015 62.51 56.27 CT密度+最大截面积+NLR 0.0187 0.884 < 0.001 87.51 82.15
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