降钙素原在重症急性胰腺炎中预测价值的临床研究  

Clinical study on the predictive value of procalcitonin in patients with severe acute pancreatitis

作　　者：王宾[1] 齐文杰[1] 王红[1] 

机构地区：[1]首都医科大学附属北京友谊医院感染内科,北京100050

出　　处：《临床和实验医学杂志》2017年第11期1110-1113,共4页Journal of Clinical and Experimental Medicine

基　　金：北京中医药科技发展资金资助项目(编号:JJ2016-12)

摘　　要：目的明确降钙素原在轻型和重症急性胰腺炎的鉴别诊断中是否具有临床预测价值。方法前瞻性地将急性胰腺炎患者分为两组(轻型和重型)。在患者纳入以及后续的治疗、抢救、随访过程中均进行降钙素原水平的检测,以及Ranson评分、急性生理学与慢性健康评分系统Ⅱ(APACHE II)评分。钙素原的检测采用ELFA检测方法;所有数据采集后建立数据库,并进行统计分析,统计方法采用Fisher's精确检验与方差分析等。结果在75例急性胰腺炎患者中,53例为轻型,22例为重型。区分轻重型降钙素原水平的截断值为0.50 ng/ml,Ranson's得分为3分,APACHE II得分为8分,其敏感度分别为100.00%、83.00%、87.00%。重复测量方差分析的结果表明在发病后6天内,重型胰腺炎患者降钙素原水平显著高于轻型胰腺炎患者(P<0.05);而随着病情的恢复,降钙素原的水平则逐渐下降。结论降钙素原是一个实用简单的指标,可以用于重症急性胰腺炎的早期鉴别诊断以及临床预后的监测。Objective To determine whether procalcitonin has clinical predictive value in differential diagnosis of mild and s pancreatitis. Methods Patients were prospectively divided into two （mild and severe acute pancreatitis） groups. The levels of procalcitonin and Ranson scores, acute physiological and chronic health evaluation scoring system II （APACHE II） were scored during the treatment, rescue and follow - up periods. The ELFA method had been applied to detect the level of procalcitonin. All these data were collected and analyzed in this study. Fishers exact test and variance analysis were used in the statistical analyses. Results Among 75 patients with acute pancreatitis, 53 pa-tients were mild and 22 patients were severe cases. The cut - off value of procalcitonin was 0. 50 ng/ml, Ransons scores were 3 points, and A-PACHE II scores were 8 points for distinguishing mild and severe acute pancreatitis, and the rates of sensitivity were 100. 00% , 83.00% and 87. 00% respectively. The results of repeated measuring ANOVA showed that the levels of procalcitonin were significantly higher in patients with severe acute pancreatitis than those of patients with mild pancreatitis （P〈0. 05） within 6 days after the onset; and the levels of procaltonin were gradually decreased with the recovery of the disease. Conclusion Procalcitonin is a simple and useful marker for the early differential diagnosisand clinical prognosis for monitoring patients with severe acute pancreatitis.

关 键 词：重症急性胰腺炎 降钙素原 预测 

分 类 号：R576[医药卫生—消化系统]