The Relationship Between CRP And LDH And Severe Acute Pancreatitis And Its Clinical Value In Evaluating Disease Severity

Objectives The aim of this article is to investigate the serum C_reaction protein(CRP)and lactate dehydrogenase(LDH)levels of acute pancreatitis,as well as the clinical value of both to evaluate the severity of the disease.Methods From January 2013 to October 2016,110 patients with acute pancreatitis(AP)admitted to the affiliated hospital of North China University of Science and Technology were selected for the study.39 patients with severe acute pancreatitis(SAP)were diagnosed.In the case group,pancreatic necrosis occurred in 18 cases,organ failure occurred in 13 cases,organ failure was associated with pancreatic necrosis in 5 cases,and was included in patients with pancreatic necrosis and organ failure.three cases died;71 patients diagnosed with mild acute pancreatitis(MAP)as control group.All patients except CT,ultrasound and other routine examinations,serum CRP,LDH levels on the 1st,3rd,5th,and 7th days after admission,and amylase(AMY)index within 24 hours after admission,acute physiology and chronic health evaluation II(Acute physiology and chronic heath evaluation II,APACHEII)scores were analyzed and compared.Independent sample t-test was used for statistics.When P<0.05 considered the difference statistically significant,it was judged according to the area under the Receiver operating characteristic curve(ROC)curve of CRP,LDH admission day 1 and APACHE II score.Clinical guidance value for predicting the severity of AP.Results 1 There was a statistically significant difference in CRP and LDH levels between the SAP group and the MAP group on days 1,3,5,and 7(P<0.05),CRP on the first day,LDH on the first day,and APACHE II on the admission curve were within the area of the ROC curve,they were 0.936,0.903,and 0.998,respectively.2 In the organ failure group and no organ failure group,CRP was significantly different on the 1st,3rd,5th,and 7th days(P<0.05),serum LDH levels were compared on the 1st,3rd,5th,and 7th days.the differences were statistically significant(P<0.05),CRP and LDH on the first day,and APACHE II on the admission curve were within the area of the ROC curve,they were 0.969,0.888,0.979,respectively.3 In the pancreatic necrosis group and non-pancreatic necrosis group,serum CRP level had significant difference on the 1st,3rd,5th and 7th days(P<0.05),serum LDH levels were on the 1st,3rd,5th,and 7th days.The difference was statistically significant(P<0.05),CRP and LDH on the first day,and APACHEII on the admission curve were within the area of the ROC curve,they were 0.893,0.887,and 0.907,respectively.Conclusions 1 The levels of CRP and LDH increased significantly in SAP group,organ failure group and pancreatic necrosis group.2 CRP and LDH have important clinical value in assessing the severity of acute pancreatitis,organ failure,and pancreatic necrosis,and can predict the occurrence of complications early.According to the results of ROC curves,they all have high accuracy,according to the Kappa value.It indicates that the CPA,LDH and APACHEII scores have a high degree of consistency,and because the APACHEII scoring system is cumbersome and involves many indicators,it makes the CRP and LDH appear to be particularly important,easy to use,and easy for patients to accept.The assessment of AP can provide help for clinical diagnosis and treatment.The sample size of this study is relatively small,and the sample size can be increased to further study.