血淀粉酶、胰脂肪酶、PCT、CRP联合检测在急性胰腺炎中的诊断价值  

Clinical significance of the combined detection of AMY,LPS,PCT and CRP in prognosis of acute pancreatitis

作　　者：张剑[1] 魏殿军[1] 

机构地区：[1]天津医科大学第二医院,天津300211

出　　处：《中国实验诊断学》2017年第5期778-780,共3页Chinese Journal of Laboratory Diagnosis

摘　　要：目的探讨血淀粉酶(AMY)、胰脂肪酶(LPS)、降钙素原(PCT)、C反应蛋白(CRP)联合检测在急性胰腺炎患者中的临床诊断价值。方法检测我院2015年6月至2016年6月150例急性胰腺炎(AP)患者按病情严重程度分为轻症急性胰腺炎(MAP)组76例和重症急性胰腺炎(SAP)组74例,75例健康人员为对照组。比较各组之间血清AMY、LPS、PCT和CRP水平的差异,并且检测不同时间点的CRP及PCT表达水平。利用SPSS17.0软件进行数据统计分析,绘制ROC曲线检测其对急性胰腺炎的诊断效能。结果 AMY、LPS:MAP组、SAP组与对照组均有统计学意义(P<0.01),但SAP组与MAP组两组间无统计学差异(P>0.05)。PCT:MAP组、SAP组与对照组均有统计学意义(P<0.01),且各组间也有统计学差异(P<0.05)。MAP组与SAP组两组PCT水平均在入院第1天达到峰值,之后逐渐降低。MAP组与同期SAP组相比较,PCT水平的差异有统计学意义(P<0.05)。CRP:MAP组、SAP组与对照组均有统计学意义(P<0.01),且各组间也有统计学差异(P<0.05)。MAP组与SAP组两组CRP水平均在入院第4天达到峰值,之后逐渐降低。MAP组与同期SAP组相比较,CRP水平的差异有统计学意义(P<0.05)。AMY、LPS、PCT和CRP联合检测时的曲线下面积(AUC)高于四个指标单独使用时的AUC。结论血清AMY、LPS、PCT和CRP联合检测可有效提升急性胰腺炎患者临床诊断准确率,值得推广。Objective To evaluate the clinical value of AMY,LPS,PCT and CRP in patients with acute pancreatitis. Methods In this retrospective study,150 patients of acute pancreatitis were consecutively included between June 2015 and June 2016 , including 76 cases of mild acute pancreatitis,severe acute pancreatitis in 74 cases and compared with 75 subjects as normal control. All patients collected venous blood in the next morning to detect the concentration of AMY, LPS,PCT and CRP. Using SPSS17.0 software for statistical analysis,and draw the ROC curve. Testing its effectiveness to the diagnosis of acute pawcreatitis. Results AMY, LPS; MAP group, SAP group and the control group were statistically significant （P〈0.01）, but there was no statistical difference between the two groups （P〈0.05）. PCT： MAP group, SAP group and the control group were statistically significant （P〈0. 01） ,and there were statistical differences among the groups （P〈0.05）. The level of PCT in the two groups reached the peak at first days after admission, and then decreased gradually. MAP group compared with the same period SAP group,the difference of PCT level was statistically significant （P〈0.05）. CRP：MAP group, SAP group and the control group were statistically significant （P 〈0. 01）, and there were statistical differences among the groups （P〈0. 05）. The level of CRP in the two groups reached the peak at fourth days after admission,and then decreased gradually. MAP group compared with the same period SAP group, the difference of CRP level was statistically significant （P〈0.05）. Combined detection of AMY,LPS, PCT and CRP in prognosis of acute pancreatitis positive rate is higher than single positive rate. Conclusion Combined detection of AMY,LPS,PCT and CRP can effectively improve the acute pancreatitis patients clinical diagnostic accuracy, and it is worth promoting.

关 键 词：血淀粉酶 胰脂肪酶 急性胰腺炎 

分 类 号：R576[医药卫生—消化系统]