降钙素原在早期预测和鉴别重症急性胰腺炎并胰周感染中的作用  

The value of procalcitonin in the prediction and differentiation of peripancreatic infection in severe acute pancreatitis patients

作　　者：詹勇强[1] 王成友[1] 张敏杰[1] 倪勇[1] 梁浩晖[1] 韩庆[1] 邓浩源[1] 

机构地区：[1]深圳市第二人民医院

出　　处：《中国感染控制杂志》2009年第4期252-254,261,共4页Chinese Journal of Infection Control

基　　金：深圳市科技计划资助项目(200405094)

摘　　要：目的检测重症急性胰腺炎（Severe acute pancreatitis，SAP）患者血清降钙素原（Procalcitonin，PCT）水平，探讨其早期预测和鉴别胰周感染的价值。方法对102例SAP患者，根据人院后2周内是否发生临床胰周感染分为感染组（IPN组，n=18）和非感染组（NI组，n=84）。每日定量（放射免疫法）和半定量（PCT-QUEST试纸）检测血清PCT水平，并记录二者感染前最高值。结果血清PCT定量检测结果示IPN组为（17．78±3．61）ng／mL，显著高于NI组（11．74±3．25）ng／mL（t=7．19，P〈0．01）；以15ng／mL为标准，其敏感度为83．33％，特异性为77．38％。PCT半定量检测亦示两组间存在显著差异，以＋＋为标准，其鉴别感染的敏感度为94．44％，特异性为39．29％（χ^2=6．17，P〈0．05）；以＋＋＋为标准，其鉴别感染的敏感度为61．11％，特异性为96．43％（χ^2=36．73，P〈0．01）。结论PCT对SAP胰周早期发生感染具有较高的预测和鉴别诊断价值。Objective To study the value of procalcitonin （PCT） in the prediction and differentiation of peripancreatic infection in severe acute pancreatitis （SAP） patients. Methods One hundred and two SAP patients were divided into infected pancreatic necrosis group （IPN group, n = 18） and non-infection group （NI group, n = 84） according to whether peripancreatic infection developed during the first 2 weeks of hospitalization. Serum PCT values of patients were monitored daily by quantitative （RIA） and semiquantitative （PCT QUEST） methods. The peak values of PCT before the infection were recorded and analyzed. Results Serum PCT level of IPN group was （17. 78 ±3. 61）ng/mL, which was significantly higher than （11.74± 3.25）ng/mL of NI group （t = 7. 19, P〈0. 01）. If the threshold value of serum PCT was set as 15ng/ml, the sensitivity and specificity of detecting infection was 83.33% and 77. 38% respectively. Semiquantitative test of PCT showed a significant difference between the two groups, setting ＂ ＋＋ ＂ as the threshold, the sensitivity and specificity of detecting infection were 94. 44% and 39. 29% respectively （χ^2 = 6. 17, P〈0. 05）; and setting ＂＋＋＋ ＂ as the threshold, they were 61. 11% and 96. 43% respectively （χ^2 = 36. 73, P〈0. 01）. Conclusion PCT detection is of great value in the prediction and differentiation of early peripancreatic infection in SAP patients.

关 键 词：降钙素原 急性胰腺炎 感染 诊断 鉴别 全身炎症反应综合征 

分 类 号：R657.51[医药卫生—外科学]