Early diagnosis and prediction of severity in acute pancreatitis using the urine trypsinogen-2 dipstick test:A prospective study  

作　　者：Erdinc Kamer Haluk Recai Unalp Hayrullah Derici Tugrul Tansug Mehmet Ali Onal 

机构地区：[1]Department of Surgery,Izmir Ataturk Training and Research Hospital,Izmir 35820,Turkey

出　　处：《World Journal of Gastroenterology》2007年第46期6208-6212,共5页世界胃肠病学杂志（英文版）

摘　　要：AIM： To evaluate the use of the trypsinogen-2 dipstick （Actim Pancreatitis） test for early diagnosis and prediction of severity in acute pancreatitis （AP）. METHODS： Ninety-two patients with AP were included in this study. The control group was 25 patients who had acute abdominal pain from non-pancreatic causes. Urine trypsinogen-2 dipstick test （UTDT） and conventional diagnostic tests were performed in all patients. Patients were divided by the Atlanta classification into two groups as having mild or severe pancreatitis. RESULTS： UTDT was positive in 87 （94.6%） of the AP patients and in two （8%） controls （P 〈 0.05）. Positive UTDT was found in 61 （92.4%） of 66 （71.7%） patients with mild pancreatitis and in all （100%） of the 26 （28.3%） with severe pancreatitis （P 〉 0.05）. UTDT positivity lasted longer in severe pancreatitis compared with that in mild pancreatitis （6.2 ＋ 2.5 d vs 2.0 ＋ 1.43 d, P 〈 0.05）. The sensitivity, specificity, positive predictive value, negative predictive value （NPV）, positive likelihood ratio （PLR） and negative likelihood ratio （NLR） of UTDT were 91%, 72%, 96.6%, 70.4%, 3.4 and 0.1, respectively. CONCLUSION： UTDT is a simple, rapid and reliable method for use on admission. It has high specificity and low NLR for early diagnosis and prediction of severity in AP. However, its relatively low NPV does not allow trypsinogen-2 dipstick test to be a stand-alone tool for diagnosis of acute pancreatitis; the use of other conventional diagnostic tools remains a requirement.瞄准：评估量杆(Actim 胰腺炎) 在尖锐胰腺炎(AP ) 为严厉的早诊断和预言测试的 trypsinogen-2 的使用。方法：有 AP 的 92 个病人在这研究被包括。控制组是从非胰腺的原因有剧烈腹的疼痛的 25 个病人。尿 trypsinogen-2 量杆测试(UTDT ) 和常规诊断测试在所有病人被执行。病人们被亚特兰大分类作为有温和或严重的胰腺炎划分成二个组。结果：UTDT 是积极的在里面(94.6%)(8%) 87 AP 病人并且在二控制(P < 0.05 ) 。积极 UTDT 在 61 被发现(92.4%) 66 (71.7%) 有温和胰腺炎并且在所有(100%) 的病人 26 (28.3%) 与严重胰腺炎(P > 0.05 ) 。UTDT 确实在温和胰腺炎与那相比在严重胰腺炎更长持续了(6.2 +/- 2.5 d 对 2.0 +/- 1.43 d， P < 0.05 ) 。敏感，特性，积极预兆的价值，否定预兆的价值(NPV ) ，积极可能性比率(PLR ) 和 UTDT 的否定可能性比率(NLR ) 分别地是 91% ， 72% ， 96.6% ， 70.4% ， 3.4 和 0.1。结论：UTDT 是为承认上的使用的一个简单、快速、可靠的方法。它在 AP 为严厉的早诊断和预言有高特性和低 NLR。然而，它的相对低的 NPV 不允许 trypsinogen-2 量杆测试是为尖锐胰腺炎的诊断的一个独立工具；另外的常规诊断工具的使用仍然是一个要求。

关 键 词：Acute pancreatitis Urine trypsinogen-2dipstick test Early diagnosis Disease severity 

分 类 号：R576[医药卫生—消化系统]