血前降钙素测定对急性重症胰腺炎的诊断价值  

Serum procalcitonin determination for the diagnosis of severe acute pancreatitis

作　　者：张彦 郝英霞 

机构地区：[1]保定第一中心医院消化内科,保定071000

出　　处：《现代仪器与医疗》2013年第4期46-49,共4页Modern Instruments & Medical Treatment

摘　　要：目的探讨血前降钙素测定对急性重症胰腺炎的诊断价值。方法选择51例急性胰腺炎患者,按Atlanta标准分为轻型(MAP)28例,重型(SAP)23例,比较轻型和重型患者发病后、24h、48h、72h血CRP、ESR、血淀粉酶和血PCT水平,并以PCT诊断试验与同期APACHEⅡ评分系统比较,确定PCT对SAP诊断的灵敏度、特异性、准确率,并观察PCT与SAP合并症的关系。结果 SAP患者血清PCT水平在入院时、24h、48h、72h PCT水平均高于MAP组(P<0.05),PCT测定结果法与APACHⅡ系统法对急性胰腺炎轻、重型的评估,差异无统计学意义(P>0.05),在发病早期、24h时血清PCT对SAP诊断的灵敏度、特异度和准确度分别为95.6%、78.6%、86.3%和82.6%、71.4%、76.4%,有无腹水及是否合并MODS,PCT的检测结果差异有统计学意义(P<0.05)。结论血清PCT水平与急性胰腺炎患者病情的严重程度有关,在发病24h内对早期SAP具有一定诊断价值,与APACHEⅡ评分系统效果相当。Objective To investigate the significance of serum procalcitonin determination for the diagnosis of severe acute pancreatitis.Methods 51 cases with acute pancreatitis were divided into mild group（MAP）28 cases,severe gourp（SAP） 23 cases by atlanta standard,then the ESR,CRP blood serum amylase and serum level of PCT on admission,24h,48h,72h were compared,and PCT diagnostic tests with the same period in APACHEⅡ system were compared also,then the diagnostic sensitivity,specificity,accuracy of the PCT on SAP were determined,PCT and SAP comorbidity relationship were observed.Results Serum PCT levels at the time of admission,24h,48h,72h with SAP group were higher than MAP group（P0.05）,PCT compares with APACHⅡ system for acute pancreatitis to distinguish wild and heavy assessment had no difference（P0.05）,Serum PCT levels for the SAP diagnostic with the sensitivity,specificity and accuracy were 95.6%,78.6%,86.3% and 82.6%,71.4%,76.4% on admission and 24h,they had statistically significant between MAP and SAP with or without ascites and whether it is combined with MODS（P0.05）.Conclusion The level of serum PCT in patients can predict the sever of acute pancreatitis,in the pathogenesis of 24h in especially for the diagnose of early SAP in 24h,and it has the same effect with APACHE Ⅱ score.

关 键 词：急性胰腺炎 前降钙素 早期诊断 预后 

分 类 号：R318[医药卫生—生物医学工程] R58[医药卫生—基础医学]