血浆胰蛋白酶原激活肽和尿胰蛋白酶原-2在急性胰腺炎预后监测中的价值  

Significance of Measurement of Plasma Trypsinogen Activation Peptide and Urinary Trypsinogen-2 Test Strip in Predicting Outcome of Severe Acute Pancreatitis

作　　者：张维新[1] 陈运和[1] 肖翔宇[1] 陈宁南[1] 

机构地区：[1]江西省人民医院急诊科,南昌330006

出　　处：《江西医学院学报》2008年第1期38-40,共3页Acta Academiae Medicinae Jiangxi

基　　金：江西省卫生厅课题(20041024)

摘　　要：目的探讨血浆胰蛋白酶原激活肽(TAP)和尿胰蛋白酶原-2在急性胰腺炎(AP)预后监测中的价值。方法86例AP患者[25例重症患者(SAP)和61例轻症患者(MAP)]在入院后1、12、24 h、3、5、7 d取血样测试TAP浓度;25例SAP于入院后1、24 h、3、5、7 d取尿样检测尿胰蛋白酶原-2浓度,并测同时点血清C-反应蛋白(CRP)含量,入院后1、24 h进行APACHEⅡ评分,并对结果对照分析。结果SAP组在入院24 h内血TAP浓度明显高于MAP组(P<0.05),而24 h后血TAP浓度两组间差异无统计学意义(P>0.05)。尿胰蛋白酶原-2在入院后1 h对SAP检测的敏感性为88.0%、特异性为85.7%,明显高于同时点CRP的敏感性56.0%、特异性74.3%(P<0.05)及同时点APACHEⅡ评分的敏感性72.0%、特异性71.4%(P<0.05);而在入院24 h,SAP组APACHEⅡ评分、尿胰蛋白酶原-2、CRP检测的敏感性、特异性比较差异无统计学意义(P>0.05)。结论血浆TAP对SAP的早期诊治有帮助,而尿胰蛋白酶原-2对AP预后具有良好的预测作用。Objective To evaluate the measurement of urinary trypsinogen-2 test strip and plasma trypsinogen activation peptide （TAP） in predicting outcome of severe acute pancreatitis （AP）. Methods Blood samples were collected for TAP concentration at 1 h,12 h,24 h,3 d,5 d, and 7 d after admission from 86 patients with acute pancreatitis [25 with severe disease （SAP） ,61 with mild disease（MAP）]; Urine samples were collected for urinary trypsinogen-2 test at 1h, 24 h,3 d,5 d and 7 d after admission from 25 patients with SAP and the results were respectively compared with those obtained with serum C-reactive protein（CRP）and the acute physiology and chronic health evaluationⅡ （APACHE Ⅱ）scores which obtained at 1 h and 24 h after admiddion. Results The differences of TAP concentration between severe and mild pancreatitis were significant at 24 h after admission（P（0.05）, but not at 24 h later（P〉0.05）. Sensitivity of urinary trypsinogen-2 for prediction of severe AP at 1h after admission was 88.0% and specificity was 85.7% ;the results were signifycantly higher than the sensitivity 56.0% and specificity 74.3% of CRP（P〈0.05）and the sensitivity 72.0% and specificity 71.4% of APACHE Ⅱ scores（P〈0.05）, respectivelybut not at 24 h after admission or late（P〉0.05）. Conclusion The determination of TAP may be helpful in the diagnosis of severe acute pancreatitis and urinary trypsinogen-2 test strip is an better marker for predicting severe acute pancreatitis than CRP and APACHE Ⅱ scores.

关 键 词：胰腺炎 急性 尿胰蛋白酶原-2 胰蛋白酶原激活肽 血浆 预后 

分 类 号：R576[医药卫生—消化系统]