降钙素原在急性胰腺炎临床应用中的研究  

Clinical value of serum procalcitonin in diagnosis of acute pancreatitis

作　　者：陈伟[1] 刘文恩[1] 谷秀梅[1] 彭婉婵[1] 李艳华[1] 刘元元[1] 李艳明[1] 

机构地区：[1]中南大学湘雅医院检验科,湖南长沙410008

出　　处：《中华医院感染学杂志》2013年第17期4324-4326,共3页Chinese Journal of Nosocomiology

基　　金：湖南省卫生厅科研基金课题(2011-008)

摘　　要：目的探讨血清降钙素原(PCT)对急性胰腺炎早期诊断、治疗效果和严重度分级的临床应用价值,快速、准确地为预后提供判断依据。方法收集2011年3月-2012年6月71例初诊为急性胰腺炎住院患者作为研究对象,根据临床诊断及《重症急性胰腺炎诊治指南》,将研究对象分为轻症急性胰腺炎(A组)、重症急性胰腺炎Ⅰ级(B组)和重症急性胰腺炎Ⅱ级(C组),21名健康体检人员作为正常对照组(D组),采集患者入院24h内和出院前血清及21名正常对照组血清,应用法国生物梅里埃公司VIDAS全自动酶联荧光分析仪检测血清PCT;应用IMANNG800双光路浊度免疫分析仪检测血清C反应蛋白(CRP),绘制受试者工作特征曲线(ROC),评价PCT诊断急性胰腺炎严重程度的价值。结果血清PCT随着胰腺炎的严重程度升高而加重,轻症急性胰腺炎与正常对照组、重症急性胰腺炎Ⅰ级与正常对照组、重症急性胰腺炎Ⅱ级与正常对照组、轻症急性胰腺炎与重症急性胰腺炎Ⅰ级、重症急性胰腺炎Ⅰ级与重症急性胰腺炎Ⅱ级严重程度比较,差异均有统计学意义;出院前各病例组血清PCT水平回落,与入住前差异均有统计学意义(P<0.01);以临床诊断为金标准,PCT分别以0.48、0.96、3.74mg/L为界诊断轻症急性胰腺炎、重症急性胰腺炎Ⅰ级和重症急性胰腺炎Ⅱ级的性能最高,曲线下面积分别为0.76、0.87和0.97,特异度分别为72.44%、74.20%和84.60%,灵敏度分别为75.00%、91.20%和95.50%。结论血清PCT检测可作为急性胰腺炎早期诊断指标,其检测结果可反映治疗效果,且对急性胰腺炎严重程度的诊断具有很好的敏感性和特异性。OBJECTIVE To study the clinical value of the serum procalcitonin（PCT） in the early diagnosis of acutepancreatitis, efficacy and grading of severity so as to provide a judgment criteria for diagnosis rapidly and accurately. METHODS We selected 71 inpatients diagnosed acute pancreatitis from Mar 2011 to Jun 2012 as the researchsubjects, divided them into the mild acute pancreatitisCA Group）,severe acute pancreatitis I（B Group） , and se-vere acute pancreatitis II （C Group） according to the clinical diagnosis and guidelines on severe acute pancreatitistreatment, while 21 healthy volunteers were set as the normal control group （D Group）. The serum of the patients24 h after hospitalization and before discharge and the serum of 21 healthy volunteers in the normal control groupwere collected. The serum PCT was analyzed with a French bio -Merieux VIDAS automatic enzymelinked fluores-cent analyzer; the serum C-reactive protein （CRP） was measured with IMANNG800 double-optical-path turbidityimmune analyzer to plot the receiver operating characteristic curve （ROC） and evaluate the value of PCT in diagno-sis of mild acute pancreatitis, severe acute pancreatitis I and severe acute pancreatitis II . RESULTS Serum PCT in-creased with the severity of the pancreatitis, there was significant difference between the mild acute pancreatitisand normal control, severe acute pancreatitis I and normal control （P = 0. 000）, severe acute pancreatitis II andnormal control group,mild acute pancreatitis and severe acute pancreatitis I,severe acute pancreatitis I and se-vere acute pancreatitis II . The levels of PCT were significantly decreased before discharge, which was significantly different from that at the time of arrival （P〈0. 001）. With clinical diagnosis as the gold standard, the best levels of PCT to diagnose mild acute panereatitis, severe acute pancreatitis I and severe acute pancreatitis II were 0.48 mg/L, 0.96 mg/L and 3.74mg/L respectively; the AUCs were 0.76.0.87 and 0.97 respectively; the valu

关 键 词：降钙素原 急性胰腺炎 C反应蛋白 

分 类 号：R446.1[医药卫生—诊断学]