随访询问了自2005年1月到2016年12月之间确诊为ERCP术后胰腺炎的一组病人。除了在ERCP术后12 - 24小时测血清磷酸盐外，还研究了一些被认为适合准确预测ERCP术后胰腺炎严重程度的病例。
纳入了重型(n =42, 22.0%)和轻中型(n =149, 78.0%)的胰腺炎患者共191例。在多变量分析中确定了预测严重ERCP术后胰腺炎的几个因素：恶性肿瘤是ERCP的主要适应症（比值比（OR）2.65，P = 0.038），全身炎症反应综合征（OR 4.49，P = 0.016）和血清磷酸盐水平（OR 1.97，P = 0.040）。在受试者操作特征分析中， ERCP术后重症胰腺炎的血清磷酸盐水平曲线下面积为0.65（95％可信区间，0.56-0.75）。预测ERCP术后重症胰腺炎的血清磷酸盐水平的最佳临界值为3.35mg / dL（敏感性，0.62;特异性，0.73）。
Utility of serum phosphate as a marker for predicting the severity of post-endoscopic retrograde cholangiopancreatography pancreatitis
To date, no reliable marker for predicting the severity of post-endoscopic retrograde cholangiopancreatography(ERCP) pancreatitis exists. A previous animal study reported a correlation between serum phosphate level and the severity ofacute pancreatitis.
: The purpose of this study was to evaluate the feasibility of serum phosphate as a marker for predicting theseverity of post-ERCP pancreatitis in humans.
: A cohort of patients that were diagnosed with post-ERCP pancreatitis between January 2005 and December 2016was queried. In addition to serum phosphate levels measured between 12 and 24 hours after ERCP, several candidatesdeemed suitable for accurately predicting the severity of post-ERCP pancreatitis were also explored.
: A total of 191 patients with severe (n =42, 22.0%) and mild-to-moderate (n =149, 78.0%) post-ERCP pancreatitiswere included. Several factors for predicting severe post-ERCP pancreatitis were identified in the multivariate analysis:malignancy as the primary indication for ERCP (odds ratio (OR) 2.65, P ¼ 0.038), systemic inflammatory response syndrome(OR 4.49, P ¼ 0.016) and serum phosphate level (OR 1.97, P ¼ 0.040). In the receiver operating characteristic analysis,the area under the curve of serum phosphate level for severe post-ERCP pancreatitis was 0.65 (95% confidence interval,0.56–0.75). The optimal cut-off value of serum phosphate level for prediction of severe post-ERCP pancreatitis was
3.35 mg/dL (sensitivity, 0.62; specificity, 0.73).
: Serum phosphate level after ERCP can be used as a reliable prognostic marker in predicting the severity ofpost-ERCP pancreatitis. Future prospective studies would be the cogent next step in validating its value.