PCT和sICAM-1对急性胰腺炎严重程度早期预测价值  

THE VALUE OF PROCALCITONIN AND SICAM-1IN EARLY PREDICTING THE SEVERITY OF ACUTE PANCREATITIS

作　　者：习晓丽[1] 张文礼[1] 

机构地区：[1]宜宾市第一人民医院消化内科,四川宜宾644000

出　　处：《齐鲁医学杂志》2017年第1期45-47,50,共4页Medical Journal of Qilu

摘　　要：目的探讨急性胰腺炎(AP)病人血清降钙素原(PCT)和可溶性细胞间黏附分子-1(sICAM-1)水平检测在AP严重程度早期评估中的临床意义。方法AP病人62例,其中中重症AP(MSAP)22例、重症AP(SAP)10例(A组),轻症AP(MAP)30例(B组),对两组病人进行急性生理与慢性病评分系统Ⅱ(APACHEⅡ)、Ranson评分和血清PCT、sICAM-1检测,分析两组血清PCT、sICAM-1与Ranson、APACHEⅡ评分的相关性,通过受试者工作特征曲线(ROC)评价血清PCT、sICAM-1对SAP的诊断效能。结果入院第1天A组血清PCT和sICAM-1水平高于B组,差异有显著性(t=9.36、7.63,P<0.05)。入院第1、4、7天,两组血清PCT和sICAM-1水平均随时间增加逐渐降低,差异有显著性(F=19.65~33.58,P<0.05);入院第1、4、7天A组血清PCT和sICAM-1水平均高于B组,差异均有统计学意义(t=7.63~13.90,P<0.05)。AP病人血清sICAM-1、PCT水平与Ranson、APACHEⅡ评分均呈显著正相关(r=0.493~0.726,P<0.05)。血清PCT和sICAM-1对SAP诊断的ROC曲线AUC分别为0.971、0.863,灵敏度分别为87.35%、69.32%,特异度分别为98.67%、90.36%。结论联合检测血清sICAM-1及PCT可有效预测AP的严重程度,为制定治疗方案提供依据。Objective To evaluate the clinical significance of serum procalcitonin（PCT）and soluble intercellular adhesion molecule-1（sICAM-1）in early prediction of severity of acute pancreatitis（AP）. Methods Sixty-two patients with AP were selected,among them,22 were moderate and severe AP（MSAP）,10 were severe AP（group A）,and 30 were mild AP（group B）.APACHE Ⅱ and Ranson system were used to score the conditions of patients in the two groups.PCT and sICAM were detected.The correlation of serum PCT and sICAM-1with Ranson score and APACHE Ⅱscore was analyzed.The diagnostic efficiency of PCT and sICAM-1for AP was evaluated using receiver operating characteristic curve（ROC）. Results On the first day of admission,serum levels of PCT and sICAM-1in group A were higher than that in group B（t=9.36,7.63;P〈0.05）.On days 1,4and 7of admission,the levels of serum PCT and sICAM-1gradually decreased with the increase of time（F=19.65-33.58,P〈0.05）.On days 1,4and 7of admission,serum levels of PCT and sICAM-1in group A were higher than that in group B,the difference was significant（t=7.63-13.90,P〈0.05）.The level of serum PCT and sICAM-1were positively correlated with Ranson and APACHE Ⅱ scores（r=0.493-0.726;P〈0.05）;the ROC curve analysis revealed the AUC of serum sICAM-1and PCT was0.971 and 0.863,respectively;the sensitivity of PCT and sICAM-1in the diagnosis of SAP was 87.35%and 69.32%,respectively;the specificity was 98.67% and 90.36%,respectively. Conclusion Combined detection of serum sICAM-1and PCT can effectively predict the severity of acute pancreatitis,and provide the basis for the development of its treatment program.

关 键 词：降钙素原 可溶性细胞间黏附分子-1 胰腺炎 

分 类 号：R576[医药卫生—消化系统]