C反应蛋白及乳酸脱氢酶对预测急性胰腺炎严重程度的诊断价值  

Value of serum CRP and LDH for evaluating severity of acute pancreatitis

作　　者：曾珺[1] 韩超群[2] 丁震[2] 

机构地区：[1]华中科技大学同济医学院附属武汉市中心医院消化内科,湖北省武汉市430014 [2]华中科技大学同济医学院附属协和医院消化内科,湖北省武汉市430014

出　　处：《世界华人消化杂志》2016年第21期3293-3298,共6页World Chinese Journal of Digestology

摘　　要：目的:评估C反应蛋白(C-reactive protein,CRP)及乳酸脱氢酶对判断急性胰腺炎严重程度的诊断价值.方法:回顾性分析2010-12/2015-12于华中科技大学同济医学院附属协和医院就诊的51例急性胰腺炎患者,其中轻型胰腺炎(mild acute pancreatitis,MAP)16例,非MAP即中重症急性胰腺炎(moderately severe acute pancreatitis,MSAP)及重症急性胰腺炎(severe acute pancreatitis,SAP)共35例,通过检测入院24 h内患者血清CRP、乳酸脱氢酶(lactate dehydrogenase,LDH)及血淀粉酶(amylase,AMY)的水平,依据CRP、LDH及A M Y的敏感性、特异性及SROC曲线判断急性胰腺炎严重程度的诊断价值.结果:血清CRP和LDH水平在非MAP组明显高于MAP组(P<0.05).CRP预测SAP敏感性、特异性、准确性分别为74.30%,81.20%,77.75%,最佳阈值为134.5 m g/L;LDH诊断SAP敏感性、特异性、准确性分别为80%,100%,90%,最佳阈值为299.5 U/L.CRP联合LDH预测SAP的敏感性、特异性、准确性分别为85.7%,87.5%,86.6%.血清AMY在MAP、非MAP组差异不大(P>0.05).结论:入院24 h内患者的CRP和LDH水平或可成为判断急性胰腺炎严重程度简单易行的指标.AIM：To evaluate the value of C-reactive protein（CRP） and lactate dehydrogenase（LDH） in the diagnosis of the severity of acute pancreatitis.METHODS：A total of 51 patients with acute pancreatitis treated from December 2010 to December 2016 at Union Hospital of Tongji Medical College,Huazhong University of Science and Technology were enrolled,including 16 cases with mild acute pancreatitis（MAP） and 35 cases with moderately severe acute pancreatitis（MSAP） or severe acute pancreatitis（SAP）.Serum levels of CRP,LDH and amylase（AMY）were measured within 24 h after admission.We compared the sensitivities,specificities and SROC curves of serum CRP,LDH and AMY to predict the severity of acute pancreatitis.RESULTS：Serum levels of CRP and LDH in the MSAP and SAP group were significantly higher than those of the MAP group（P〉0.05）.The sensitivity,specificity and accuracy of CRP were74.3%,81.2%,and 77.75%,respectively,and the cut-off level for predicting the severity of AP was134.5 mg/L.For LDH,the sensitivity,specificity and accuracy were 80%,100%,and 90%,respectively,and the cut-off level was 2995 U/L.There was no significant difference in serum AMY levels in all groups（P〈0.05）.The sensitivity,specificity and accuracy of combined CRP and LDH were 85.7%,87.5%,and 86.6%,respectively.CONCLUSION：Serum levels of CRP and LDH are simple and useful indexes in predicting poor outcome of acute pancreatitis.

关 键 词：C反应蛋白 乳酸脱氢酶 急性胰腺炎 诊断 

分 类 号：R576[医药卫生—消化系统]