Correlation between early blood routine，coagulation function indicators and spiral CT perfusion parameters in patients with acute pancreatitis and their guiding value for prognosis

doi:10.3877/cma.j.issn.2095-2015.2025.02.003

Abstract

Abstract:

Objective

To investigate the correlation between early blood routine，coagulation function indicators，and spiral CT perfusion parameters in patients with acute pancreatitis （AP），as well as their predictive ability for the prognosis of AP patients.

Methods

A retrospective analysis was conducted on 100 AP patients admitted between June 2023 and June 2024. The patients were divided into two groups based on their mortality status： the non-death group and the death group. Differences in early blood routine，coagulation indicators，and spiral CT perfusion parameters between the two groups were compared. The correlation between blood routine，coagulation indicators，and spiral CT perfusion parameters was analyzed using Pearson correlation. The predictive ability of blood routine and coagulation indicators for the prognosis of AP patients was evaluated using ROC curves and multivariate logistic regression analysis.

Results

In the death group，neutrophil count，neutrophil-to-lymphocyte ratio （NLR），platelet count，activated partial thromboplastin time （APTT），fibrinogen （FIB），D-dimer （DD），and computed tomography severity index （Balthazar CTSI） score were significantly higher than those in the non-death group. The lymphocyte count，MPV level，blood flow （BF） and blood volume （BV） from the spiral CT perfusion parameters were significantly lower in the death group compared to the non-death group （P＜0.05）. Logistic regression analysis showed that NLR （OR=1.224，95% CI： 1.116-2.368），DD （OR=1.962，95% CI：1.438-2.529），BF （OR=0.569，95% CI： 0.258-0.815），BV （OR=0.462，95% CI： 0.316-0.927），and Balthazar CTSI （OR=1.485，95% CI： 1.345-3.973） were independent risk factors affecting the prognosis of AP patients. Pearson correlation analysis showed that NLR and DD were negatively correlated with spiral CT perfusion parameters BF and BV，and positively correlated with Balthazar CTSI score （P＜0.05）. ROC curve analysis showed that the area under the curve （AUC） for NLR was 0.752 （95% CI： 0.641-0.863），for DD was 0.779 （95% CI： 0.675-0.883），and for the combined NLR+DD was 0.923 （95% CI： 0.861-0.984）.

Conclusion

NLR and DD are correlated with spiral CT perfusion parameters BF and BV and Balthazar CTSI score，and they can be used as indicators for predicting the prognosis of AP patients.

Key words: Acute pancreatitis, Spiral CT, D-dimer, Neutrophil-to-lymphocyte ratio

Yanghui Ou, Zhihong Zhang, Yujun Yuan, Shi Lu. Correlation between early blood routine，coagulation function indicators and spiral CT perfusion parameters in patients with acute pancreatitis and their guiding value for prognosis[J]. Chinese Journal of Digestion and Medical Imageology(Electronic Edition), 2025, 15(02): 107-111.

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URL: https://zhxhbyyxzz.cma-cmc.com.cn/EN/10.3877/cma.j.issn.2095-2015.2025.02.003

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Figures/Tables 5

变量指标	非死亡组（n=73）	死亡组（n=27）	t/χ ²	P
年龄（岁， $\overset{ˉ}{x}$ ± s ）	45.13±5.44	49.23±7.05	0.518	0.542
男/女（例）	40/33	14/13	0.069	0.824
BMI（kg/m²， $\overset{ˉ}{x}$ ± s ）	24.51±4.24	25.81±4.71	0.162	0.728
初诊病程（h， $\overset{ˉ}{x}$ ± s ）	19.18±4.33	20.61±5.15	0.094	0.892
白细胞计数（×10⁹/L， $\overset{ˉ}{x}$ ± s ）	8.25±3.21	9.42±2.37	1.043	0.348
中性粒细胞计数（×10⁹/L， $\overset{ˉ}{x}$ ± s ）	5.53±1.58	8.33±2.26	12.746	0.003
淋巴细胞计数（×10⁹/L， $\overset{ˉ}{x}$ ± s ）	1.75±0.48	1.34±0.39	4.341	0.044
NLR（ $\overset{ˉ}{x}$ ± s ）	2.78±1.34	5.71±1.69	21.837	＜0.001
MPV（fl， $\overset{ˉ}{x}$ ± s ）	17.35±4.14	12.91±6.78	18.367	0.001
RDW（%， $\overset{ˉ}{x}$ ± s ）	13.09±0.36	14.68±1.23	1.324	0.332
血小板计数（×10⁹/L）	180.67±84.02	153.78±87.64	6.647	0.034
PDW（%， $\overset{ˉ}{x}$ ± s ）	13.17±2.39	13.75±2.62	0.952	0.755
TT（s， $\overset{ˉ}{x}$ ± s ）	14.18±3.16	16.22±3.21	3.132	0.067
PT（s， $\overset{ˉ}{x}$ ± s ）	12.73±2.52	14.14±1.71	2.253	0.122
APTT（s， $\overset{ˉ}{x}$ ± s ）	29.27±4.37	38.45±3.65	13.824	0.003
DD（mg/L， $\overset{ˉ}{x}$ ± s ）	0.62±0.24	1.44±0.36	14.385	＜0.001
FIB（g/L， $\overset{ˉ}{x}$ ± s ）	2.95±0.54	4.22±0.34	10.314	0.004

变量指标	非死亡组（n=73）	死亡组（n=27）	t/χ ²	P
年龄（岁， $\overset{ˉ}{x}$ ± s ）	45.13±5.44	49.23±7.05	0.518	0.542
男/女（例）	40/33	14/13	0.069	0.824
BMI（kg/m²， $\overset{ˉ}{x}$ ± s ）	24.51±4.24	25.81±4.71	0.162	0.728
初诊病程（h， $\overset{ˉ}{x}$ ± s ）	19.18±4.33	20.61±5.15	0.094	0.892
白细胞计数（×10⁹/L， $\overset{ˉ}{x}$ ± s ）	8.25±3.21	9.42±2.37	1.043	0.348
中性粒细胞计数（×10⁹/L， $\overset{ˉ}{x}$ ± s ）	5.53±1.58	8.33±2.26	12.746	0.003
淋巴细胞计数（×10⁹/L， $\overset{ˉ}{x}$ ± s ）	1.75±0.48	1.34±0.39	4.341	0.044
NLR（ $\overset{ˉ}{x}$ ± s ）	2.78±1.34	5.71±1.69	21.837	＜0.001
MPV（fl， $\overset{ˉ}{x}$ ± s ）	17.35±4.14	12.91±6.78	18.367	0.001
RDW（%， $\overset{ˉ}{x}$ ± s ）	13.09±0.36	14.68±1.23	1.324	0.332
血小板计数（×10⁹/L）	180.67±84.02	153.78±87.64	6.647	0.034
PDW（%， $\overset{ˉ}{x}$ ± s ）	13.17±2.39	13.75±2.62	0.952	0.755
TT（s， $\overset{ˉ}{x}$ ± s ）	14.18±3.16	16.22±3.21	3.132	0.067
PT（s， $\overset{ˉ}{x}$ ± s ）	12.73±2.52	14.14±1.71	2.253	0.122
APTT（s， $\overset{ˉ}{x}$ ± s ）	29.27±4.37	38.45±3.65	13.824	0.003
DD（mg/L， $\overset{ˉ}{x}$ ± s ）	0.62±0.24	1.44±0.36	14.385	＜0.001
FIB（g/L， $\overset{ˉ}{x}$ ± s ）	2.95±0.54	4.22±0.34	10.314	0.004

组别	例数	BF（mL·100 g^-1·min^-1）	BV（mL/100 g）	MTT（s）	PS（mL·100 g^-1·min^-1）	Balthazar CTSI（分）
非死亡组	73	90.51±18.51	18.12±6.61	7.26±1.51	32.61±9.51	4.22±1.05
死亡组	27	65.64±17.05	8.61±2.44	8.06±1.86	40.81±10.16	8.23±1.89
t		16.516	21.546	0.819	3.618	14.851
P		＜0.001	＜0.001	0.706	0.092	＜0.001

研究变量	β	标准误	Wald χ ²	P	OR	95% CI
NLR	0.634	1.102	7.357	0.016	1.224	1.116～2.368
DD	0.908	1.629	8.638	0.010	1.962	1.438～2.529
BF	0.715	0.825	6.126	0.024	0.569	0.258～0.815
BV	0.799	0.719	5.842	0.016	0.462	0.316～0.927
Balthazar CTSI	0.799	1.846	8.062	0.008	1.485	1.345～3.973

病情评价指标	检测指标	r 值	P 值
BF	NLR	-0.763	0.002
	DD	-0.512	0.034
BV	NLR	-0.628	0.015
	DD	-0.723	0.005
Balthazar CTSI	NLR	0.742	0.003
	DD	0.622	0.018

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