Acute pancreatitis (AP) is one of the common gastrointestinal emergencies, and the disease progression of moderately severe and severe AP is rapid. Early and accurate identification is crucial for effective intervention and prognosis assessment. there is still a lack of effective and simple predictive indicators.

To investigate the early dynamic changes and predictive value of the systemic inflammation response index (SIRI) in patients with AP.

A total of 221 AP patients who met the inclusion and exclusion criteria at the Department of Gastroenterology, Beijing Tiantan Hospital, Capital Medical University, were included as study subjects from August 2020 to March 2023. According to the revised 2012 Atlanta criteria, patients were categorized into mild group (MAP group, mild acute pancreatitis) and non-mild group (non-MAP group, including moderate severe and severe acute pancreatitis). The SIRI values (SIRI 0 h, SIRI 48 h) and C-reactive protein (CRP) levels (CRP 0 h, CRP 48 h) during admission and within 48 hours of admission for the patients were collected by reviewing cases. The receiver operating characteristic (ROC) curve was plotted, and the area under the curve (AUC) was calculated to analyze the predictive value of SIRI for non-MAP and compare it with CRP as a common clinical indicator of inflammation.

A total of 221 AP patients were finally included, 102 with MAP and 119 with non-MAP. SIRI 0 h and SIRI 48 h were higher in patients in the non-MAP group than in the MAP group (P<0.001). The ROC curve showed that the AUC for SIRI 0 h and SIRI 48 h in predicting non-MAP were 0.685 (95%CI=0.615-0.756) and 0.753 (95%CI=0.689-0.816), respectively, with no significant difference with CRP [0.607 (95%CI=0.533-0.681) and 0.752 (95%CI=0.687-0.817) ] during the corresponding time intervals (Z=1.67, P=0.095; Z=0.02, P=0.981). The optimal cut-off value for SIRI 48h to predict non-MAP was 2.49, with sensitivity, specificity, positive predictive value, and negative predictive value of 81.51%, 58.82%, 69.78%, and 73.17%, respectively.

SIRI is an affordable and readily available test that can be used as an indicator for assessing the severity of early-stage AP.

急性胰腺炎（AP）是常见的消化系统急症之一，中度重症及重症AP疾病进展迅速，早期准确识别对其防治及预后评估具有重要意义，但目前仍缺乏有效、简便的预测指标。

探讨AP患者全身炎症反应指数（SIRI）的早期动态变化及其对AP严重程度的预测价值。

选取2020年8月—2023年3月入住首都医科大学附属北京天坛医院消化内科且符合纳入及排除标准的AP患者221例为研究对象。根据2012年修订版亚特兰大分类标准，将患者分为轻症组（MAP组，轻症AP）和非轻症组（non-MAP组，包括中度重症及重症AP）。通过查阅病例收集患者入院时、入院后48 h内的SIRI值（SIRI 0 h、SIRI 48 h）和C反应蛋白（CRP）（CRP 0 h、CRP 48 h）。应用受试者工作特征（ROC）曲线，计算ROC曲线下面积分析SIRI预测non-MAP的价值并与临床常用炎症指标CRP进行比较。

最终共纳入221例AP患者，其中MAP组102例，non-MAP组119例。non-MAP组患者SIRI 0 h、SIRI 48 h均高于MAP组（P<0.001）。ROC曲线显示，SIRI 0 h、SIRI 48 h预测non-MAP的AUC分别为0.685（95%CI=0.615~0.756）、0.753（95%CI=0.689~0.816），与同时间段的CRP[0.607（95%CI=0.533~0.681），0.752（95%CI=0.687~0.817）]比较，差异无统计学意义（Z=1.67、P=0.095；Z=0.02、P=0.981）。SIRI 48 h预测non-MAP的最佳临界值为2.49，灵敏度、特异度、阳性预测值和阴性预测值分别为81.51%、58.82%、69.78%和73.17%。

SIRI是一种价格低廉、易于获得的检测方法，可作为早期AP严重程度的评估指标。