Objective To evaluate the role of mean platelet volume/platelet count ratio (MPV/PLT) in the evaluation of renal injury in severe acute pancreatitis (SAP).

Methods A total of 60 patients with SAP were divided into survival group (n=42) and death group (n=18) based on their 28 days survival after admission.SAP patients were divided into acute kidney injury (AKI) group (n=23) and non-AKI group (n=37) according to whether they fulfilled the diagnostic criteria of AKI.The baseline data and clinical data of the patients, including age, gender, underlying diseases (hypertension, diabetes mellitus), APACHE Ⅱ score, SOFA score, mean platelet volume (MPV), platelet count (PLT), C reaction protein (CRP), creatinine (Scr) and blood urea nitrogen (BUN), were collected after admission.The correlation between MPV/PLT and APACHE Ⅱ score, SOFA score and CRP of patients at admission was analyzed using Pearson correlation.The predictive value of MPV/PLT for AKI condition combined with SAP was analyzed using receiver operating characteristic (ROC) curve.Multivariate logistic regression was used to analyze the independent risk factors of SAP combined with AKI.

Results In terms of gender, age and underlying diseases (hypertension, diabetes mellitus), there were no significant differences between non-AKI group and AKI group (P>0.05).The CRP, SCR, BUN, MPV, SOFA scores and APACHE Ⅱ scores of patients in the AKI group were significantly higher than those in the non-AKI group (P < 0.05 to P < 0.01).The PLT levels of patients in the AKI group were significantly lower than those in the non-AKI group (P < 0.01).In terms of gender, there was no significant difference between survival group and death group (P>0.05).The age, CRP, SCR, BUN, MPV, SOFA score and APACHE Ⅱ score of patients in the death group were significantly higher than those in the survival group (P < 0.05 to P < 0.01).The PLT levels of patients in the death group were significantly lower than those in the survival group (P < 0.05).Pearson correlation analysis showed that MPV/PLT was significantly correlated with APACHE Ⅱ score, SOFA score and CRP in SAP patients (r=0.725, 0.818, 0.747, P < 0.01).ROC curve analysis showed that MPV/PLT had a sensitivity of 91.30% and 94.40% and specificity of 70.30% and 57.10%, respectively, with an area under the ROC curve of 0.616 and 0.816, respectively, for predicting SAP combined with AKI and 28-d death.Multivariate logistic regression analysis of SAP combined with AKI showed that MPV/PLT, BUN and Scr could be used as independent risk factors for determining SAP combined AKI (P < 0.05), while APACHE Ⅱ score, SOFA score and CRP could not be used as independent risk factors for SAP combined AKI (P>0.05).

Conclusions Elevated MPV/PLT can early predict the occurrence of SAP combined with AKI and plays an important value in evaluating the prognosis of patients, especially elevated MPV/PLT can be used as an independent risk factor for judging SAP combined with AKI.