The relationship between serum lipoprotein (a),procalcitonin,red blood cell distribution width levels and the severity of acute pancreatitis and prognostic value

QIN Nai-yu; CHEN Ken; TIAN Wei-wei

doi:10.16048/j.issn.2095-5561.2024.01.05

Abstract：Objective To investigate the relationship between serum lipoprotein(a)[Lp (a)],procalcitonin(PCT),red blood cell distribution width(RDW) levels and the severity of acute pancreatitis(AP) and its prognostic value. Methods A total of 180 patients with AP admitted to Rugao People's Hospital from January 2022 to December 2022 were selected as the study objects. According to the severity of AP,the patients were divided into mild AP group(n=75),moderate-severe AP group(n=54) and severe AP group(n=51). According to the prognosis,the patients were divided into good prognosis group(n=137) and poor prognosis group(n=43). The general data of the patients were collected,and the blood biochemical indexes and serum Lp(a),PCT and RDW levels were routinely detected. Spearman correlation analysis was used to analyze the correlation between Lp(a),PCT,RDW and acute physiology and chronic health evaluation Ⅱ(APACHE Ⅱ). Logistic regression model was used to analyze the independent risk factors for poor prognosis of AP. The receiver operating characteristic(ROC) curve was used to evaluate the predictive value of Lp(a),PCT and RDW for the prognosis of AP. Results The levels of serum Lp(a),PCT,RDW and APACHE Ⅱ scores in the moderate-severe AP group and severe AP group were higher than those in the mild AP group,and those in the severe AP group were higher than the moderate-severe AP group,the differences were statistically significant(P<0.05). Spearman correlation analysis showed that serum Lp(a),PCT and RDW levels were positively correlated with AP severity(APACHE Ⅱ score,r=0.711,0.874,0.759,P<0.001). APACHEⅡ score,Lp(a),PCT,RDW,bedside index for severity in acute pancreatitis score and Ranson score were independent risk factors for poor prognosis of AP(P<0.05). The area under the ROC curve of serum Lp(a),PCT,RDW and their combination in predicting poor prognosis of AP were 0.816,0.921,0.793 and 0.951,respectively,and the value of their combination was the highest. Conclusion Serum Lp(a), PCT and RDW levels were positively correlated with the severity of AP and were independent risk factors for poor prognosis of AP. The combination of three factors has the highest predictive value for poor prognosis of AP.