血清淀粉酶、脂肪酶联合C反应蛋白在急性胰腺炎诊断中的意义  

Meaning of Acute Pancreatitis Diagnosis by Amylase,Lipase and C-creactive Protein

作　　者：黄木荣[1] 胡丽婷 谢建敏[1] 李亚红[1] 张成禄[1] 黎运西[1] 周远青[1] 

机构地区：[1]南方医科大学附属顺德第一人民医院检验科,广东顺德528300 [2]湖北中医药大学,湖北武汉430065

出　　处：《黑龙江医学》2013年第8期659-662,共4页Heilongjiang Medical Journal

基　　金：2011年佛山市顺德区医学科研立项(2011013)

摘　　要：目的探讨血清淀粉酶(AMY)、脂肪酶(LPS)、C反应蛋白(CRP)联合检测对急性胰腺炎(AP)的早期诊断与病情评估的参考价值,以及对非AP急腹症的鉴别诊断意义。方法分别检测9例重型胰腺炎(SAP)患者和60例轻型胰腺炎(MAP)患者血清AMY、LPS、CRP水平,并与48例健康人对照组进行比较。同时,还检测了25例非AP急腹症患者血清AMY、LPS、CRP水平,与AP患者的检测结果进行比较。对单项和联合检测进行灵敏度、特异度及准确度的比较,并通过受试者工作特征曲线(ROC曲线)对诊断试验进行准确性评价。结果 AP患者血清中的CRP水平高于对照组,且入院时SAP患者血液中的CRP比MAP患者高(P<0.05),AP患者AMY、LPS高于非AP急腹症患者(P<0.05),ROC曲线中血清AMY、LPS的曲线下面积(AUC)较高,两者有较高准确性,三者联合检测能提高AP诊断的灵敏度(95.8%)、特异度(100.0%)和准确度(96.8%)。结论 CRP是鉴别SAP和MAP的良好指标,联合检测AMY、LPS和CRP可作为AP早期诊断、评估疾病严重程度的一个独立衡量标准,适用于AP与非AP急腹症的鉴别诊断,值得临床推广应用。Objective To explore the renference value of the united determination by serum AMY、LPS and CRP for differential diagnosis of AP and acute abdomen except AP.Methods Examing peripheral blood AMY、LPS and CRP levels of 9 patients with severe acute pancreatitis(SAP) and 60 patients with mild acute pancreatitis(MAP),and the results were compared with those of healthy subjects.At the same time,serum AMY、LSP and CRP levels of 25 patients with acute abdomen except AP were examed,and the results were compared with those of the AP patients.The sensitivity,specificity and accuracy of each individual project were compared with those of the united determination project,the accuracy though Receiver operating characteristic(ROC) curves were assessed.Results The serum levels of CRP with AP were significanty higher than those of the healthy group,and the results of SAP group were significantly higher than MAP group (P <0.05).The serum levels of AMY and LPS with AP were significanty higher than those of acute abdomen except AP ones(P <0.05).The areas under the curve of AMY and LPS in Receiver operating characteristic(ROC) curves for AP were relatively high,that means AMY and LPS have relative high accuracy.The united detection of AMY,LPS and CRP could improve the sensitivity to 95.8%,the specificity to 100.0% and the accuracy to 96.8%.Conclusion CRP is a good measure indicator for differential diagnosis of SAP and MAP.The united monitoring of AMY,LPS and CRP can be used as an independent measure of AP for early diagnosis and the disease severity assessment.It also can be applicable for differential diagnosis between AP and acute abdomen except AP.The united detection is worthy of clinical application.

关 键 词：急性胰腺炎 淀粉酶 脂肪酶 C反应蛋白 

分 类 号：R657.51[医药卫生—外科学]