Correlation of Apo B/A1,SAA and PCT with the severity of acute pancreatitis and their potential in predicting the outcome

CUI Hongping; DAI Hongbin; LI Yaping

doi:10.3969/j.issn.1002-7386.2023.24.002

Abstract：Objective To investigate the correlation of the Apolipoprotein B/Apolipoprotein A1(Apo B/A1),serum amyloid A(SAA)and plateletcrit(PCT)with the severity of acute pancreatitis,and their potential in predicting the outcome.Methods A total of 102 patients with acute pancreatitis admitted to our hospital were selected.Apo B/A1,SAA and PCT at baseline were compared in acute pancreatitis patients with different characteristics of the gender,age,body mass index(BMI),disease severity classification,the modified CT severity index(MCTSI),and the bedside index for severity in acute pancreatitis(BISAP).According to the outcome,patients were divided into death group(n=23)and survival group(n= 79).Apo B/A1,SAA and PCT at baseline,and 3 and 7 days after treatment were compared between groups.The Spearman or Pearson correlation analysis was performed to identify the correlation of Apo B/A1,SAA and PCT with the disease severity classification,MCTSI and BISAP.Multivariate Logistic regression was used to analyze the influencing factors for the outcome of acute pancreatitis.The potential of Apo B/A1,SAA,and PCT at baseline,and 3 and 7 days after treatment and their combined detection in predicting the outcome of acute pancreatitis was analyzed by the receiver operating characteristic(ROC)curves.Results Apo B/A1,SAA and PCT increased successively in patients with mild,moderate and severe acute pancreatitis,with significant differences in pairwise comparisons(P<0.05).Apo B/A1,SAA and PCT in acute pancreatitis patients with MCTSI≥4 were significantly higher than those with<4(P<0.05).Apo B/A1,SAA and PCT in acute pancreatitis patients with BISAP≥3 were significantly higher than those with<3(P<0.05).Correlation analysis showed that Apo B/A1,SAA and PCT were positively correlated with the disease severity classification,MCTSI and BISAP(P<0.05).The disease severity classification,MCTSI and BISAP in the death group were significantly higher than those of the survival group(P<0.05).Apo B/A1,SAA and PCT at 3 and 7 days after treatment in the death group were significantly higher than those of the survival group(P<0.05).Multivariate Logistic regression analysis showed that Apo B/A1,SAA and PCT were influencing factors for the outcome of acute pancreatitis(P<0.05).The area under curve(AUC)of Apo B/A1,SAA and PCT and their combined detection at 7 days after treatment was all significantly larger than that at 3 days after treatment,and at baseline,which,at 3 days after treatment,was all significantly larger than that at baseline(P<0.05).The largest AUC(0.940,95%CI:0.875,0.977)was detected in the combined detection at 7 days after treatment,with the sensitivity and specificity of 91.30%and 87.34%,respectively.Conclusion Apo B/A1,SAA and PCT in acute pancreatitis patients are correlated with the severity and outcome.Their combined detection is expected to be a reliable method to predict the outcome of acute pancreatitis,thus providing valuable reference information for clinical diagnosis and treatment and improving the prognosis.