Abstract: Objective To explore the application value of dynamic changes of heparin-binding protein and procalcitonin in predicting acute pancreatitis co-infection. Methods A total of 64 patients with acute pancreatitis diagnosed and treated in the Emergency Department of the First Affiliated Hospital of Bengbu Medical College from December 2018 to December 2019 were collected. They were divided into simple acute pancreatitis group and acute pancreatitis co-infection group according to whether the patients were infected with peripancreatic infection during hospitalization, 32 patients in each group. The plasma concentrations of heparin-binding protein(HBP) and procalcitonin(PCT) on the day of diagnosis(D1) and the day 7(D7) after treatment were measured. Actively intervened and treatment were preformed in the acute pancreatitis co-infection group. The t test was used to compare the differences in HBP and PCT levels between the two groups. The receiver operating characteristic(ROC) curve analysis was used to calculate their threshold value, specificity and sensitivity. Results HBP levels in the simple acute pancreatitis group and the acute pancreatitis co-infection group group were as follows: D1 [(61.97±34.84) ng/mL vs.(130.12±45.76) ng/mL] and D7 [(8.60±2.91) ng/mL vs.(10.08±3.16) ng/mL, all P<0.05]. The PCT level were as follows: D1 [(1.82±0.65) ng/mL vs.(4.48±2.58) ng/mL] and D7 [(0.50±0.21) ng/mL vs.(0.64±0.37) ng/mL, all P<0.05]. The area under the ROC curve of HBP was 0.895, sensitivity 90.60%, specificity 78.10%; the area under the ROC curve of PCT was 0.899, sensitivity 81.30%, specificity 96.90%; and the area under ROC curve of HBP combined with PCT was 0.981, the sensitivity was 96.90%, the specificity was 65.60%. Conclusion HBP and PCT can be used as indicators to predict the infection of acute pancreatitis, and combined detection can significantly improve the sensitivity, which is conducive to early detection and treatment of patients with pancreatitis co-infection.