血浆胰蛋白酶原激活肽水平与重症急性胰腺炎胰腺坏死的相关性研究  

Correlation Study between Trypsinogen Activation Peptide Levels in Plasma and Pancreatic Necrosis in Patients with Severe Acute Pancreatitis

作　　者：程征宇[1] 黄宗文[1] 夏庆[1] 郭佳[1] 陈燕[1] 马悦[1] 林子琦[1] 

机构地区：[1]四川大学华西医院中西医结合科,成都610041

出　　处：《华西医学》2010年第3期481-483,共3页West China Medical Journal

基　　金：国家科技支撑计划项目(2006BA104A15)

摘　　要：目的探讨血浆胰蛋白酶原激活肽(trypsinogen activation peptide,TAP)水平与重症急性胰腺炎(severe acute pancreatitis,SAP)胰腺坏死的关系。方法 2008年6月1日-2008年12月31日,采用ELISA法测定本院的35例SAP患者血浆TAP水平,并与胰腺增强CT扫描结果作对比,分析血浆TAP水平与胰腺坏死的关系,以及SAP无胰腺坏死组与SAP胰腺坏死组血浆TAP水平的差异。结果入院时血浆TAP水平预测胰腺坏死的最佳截值点是10.43nmol/mL,其敏感性、特异性、阳性预测值、阴性预测值分别为75%、73.9%、60%、15%,阳性比为2.87,阴性比为0.338。入院第1天血浆TAP水平预测胰腺坏死的最佳截值点是6.91μmol/L,其敏感性、特异性、阳性预测值、阴性预测值分别为90.9%、65.2%、55.6%、6.3%,阳性似然比为2.61,阴性似然比为0.001。SAP胰腺坏死组入院时、入院第一天血浆TAP水平高于SAP无胰腺坏死组(P<0.05)。结论血浆TAP水平变化与SAP病情变化密切相关,病程早期检测血浆TAP水平有助于SAP患者胰腺坏死的预测。Objective To investigate the correlation between trypsinogen activation peptide （TAP） levels in plasma and pancreatic necrosis in patients with severe acute pancreatitis （SAP）. Methods The plasma TAP levels in 35 patients with SAP were measured by ELISA methods, which were compared with the result of enhanced spiral CT scanning of pancreas. The relationship between plasma TAP levels and pancreatic necrosis was analyzed and the differences of the plasma TAP levels of the two groups was compared, one of which was the group of SAP patients without pancreatic necrosis and the other was the group of SAP patients with pancreatic necrosis. Results On admission, the optimal cutoff value of forecasting the pancreas necrosis by the plasma TAP levels was 10.43 nmol/mL with sensitivity, specificity, positive predictive value, negative predictive value of 75%, 73.9%, 60%, 15% respectively and posi- tive likelihood ratio 2.87, negative likelihood ratio 0. 338. On the first day the optimal cutoff value of the plasma TAP levels predicting in pancreatic necrosis was 6.91 /2mol/L with sensitivity, specificity, positive predictive value, negative predictive value of 90.9%, 65.2%, 55.6%, 6.3% respectively and positive likelihood ratio was 2.61, negative likelihood ratio was 0. 001. The plasma TAP levels in the SAP pancreatic necrosis group were higher than the SAP without pancreatic necrosis group （P〈0.05） on admission and the first day. Conclusion The plasma TAP levels are related to the development of SAP and the measurement of plasma TAP may contribute to predict pancreatic necrosis of the SAP patients.

关 键 词：血浆胰蛋白酶原激活肽 重症急性胰腺炎 胰腺坏死 

分 类 号：R576.1[医药卫生—消化系统]