MSCT Evaluation The Severity Of Acute Pancreatitis With Liver Damage Correlation Study

Objective: To investigate the correlation between the severity of acute pancreatitis (AP) in MSCT images and liver function,to learn the relationship between the Acute Pancreatitis severity and liver damage probability. According to their correlation to evaluate and predict the probability of liver damage.Methods: Retrospective analysis 60 cases of acute pancreatitis with MSCT images and clinical data.According to the MSCT Severity Index Score(CTSI) and the Balthazar standard (table 1),divide these cases into mild (0-3 points), medium (4-6 points), severe (7-10 points) three groups.Adopt the major indexes of reflecting the liver damage from clinical materials:Alanine Aminotransferase(ALT) and serum Aspartate Aminotransferase(AST), ALT >40U/L or AST>40U/L was thinked liver damaging.The quantity of ALT and AST is very low in normal serum, but liver cell membrane permeability increase when liver cell damage, the cytoplasm of ALT and AST released into the plasma,Cause ALT and AST increase, in the moderate degree of liver cell damage, ALT leakages rate far more than the AST, Besides ALT and AST plasma half-life respectively by 47 hours and 17 hours, so ALT implys hepatocyte injury more sensitivity than AST. But in severe liver cell damage, the mitochondrial membrane also is damaged, causing AST release,and serum AST/ALT ratio increase.So any or both of them was higher than normal, were thinked liver damage, so we select AST or ALT abnormality as the index of the liver damage.Accordance with acute pancreatitis CT Severity Index Score get light, medium, heavy three groups, and according to liver damage index will divide these cases into negative group and positive group.Use SPSS13.0 software with chi-square test, thinking that there is significant differences when P<0.05. In addition, according to the performance of CT images will divide the 60 cases into edema type and necrosis of Acute pancreatitis,analyze their liver function index(ALT and AST)and comparison,SPSS13.0 package was Used for data analysis, when P<0.05 considered having significant difference.Results:1 In selected 60 cases, according to CT Severity Index evaluation criterion, mild of 21 cases, moderate of 28 cases, severe 11 cases, in whole cases respectively proportion of 35.0%, 46.7%, 18.3%.2 In selected 60 cases, 27 cases abnormal of AST or ALT, no abnormality of AST or ALT were 33 cases, the percentages were 45.0%, 55.0% respectively.3 According to the Acute Pancreatitis CT Severity Index evaluation criterion, mild Acute Pancreatitis with 21 cases, there are 10 patients with liver damage indexs abnormal increase,the liver damage is 47.6%, 28 patients with moderate Acute Pancreatitis,13 patients anomal, the liver damage is 46.4%; 11 cases of severe Acute Pancreatitis, liver damage has 10 cases account 90.0% (table 2).4 To the light, medium, heavy of three groups Acute Pancreatitis, compare with the two groups of witch in accordance with the abnormal liver damage index, using SPSS13.0 packages chi-square test, the overall between of test statistics have statistically significant differences, P = 0.03 < 0.05.5 In light, medium, and severe Acute Pancreatitis of pairwise comparison, will segmentate 3x2 tables into three separate the four-layer table chi-square test, to ensure that the probability of type I wrongαnot change, the standard ofαredefinedα'=0.0125, P<0.0125 is statistically significant.According to this standard,only between moderate and severe has statistically significant(P =0.012<0.0125),mild and moderate, mild and severe were no significant difference (P = 0.58, P = 0.018 respectly) (table 3).6 In adopted 60 cases of AP, 48 cases of Edema type and Necrosis 12 patients. In 48 patients with liver function indexs abnormal have 14 cases(29.0%), and in 12 cases with liver damage have 9 cases(75.0%).The incidence of AST or ALT abnormal in Necrosis type is obviously higher than Edema type Acute Pancreatitis. Difference is statistically significant (P = 0.01<0.05).Conclusions:1 According to Acute Pancreatitis CT Severity Index Score, there is relevance between the light, medium, heavy three groups and liver damage on aggregate.2 According to the results of pairwise comparison,the correlation is only limited in moderate and severe groups,that is to say when the score is higher than the moderate,with the score increasing,the liver injury probability increase.While according to score in below of the moderate ,which is not as an index of prediction AP with liver injury occurrence probability.3 The rate of liver damage from Acute Necrotizing pancreatitis is higher than Edema type Acute Pancreatitis.