血清前降钙素的监测对ERCP术后胰腺炎的诊断价值  

Diagnostic value of serum procalcitonin monitoring in pancreatitis after ERCP

作　　者：尹毅霞[1] 黄赞松[1] 何守搞[1] 覃月秋[1] 

机构地区：[1]右江民族医学院附属医学院消化内科,百色533000

出　　处：《右江医学》2017年第5期527-530,共4页Chinese Youjiang Medical Journal

基　　金：广西医疗卫生适宜技术研究与开发课题项目(S201318-03)

摘　　要：目的探讨血清前降钙素(PCT)在经内镜逆行胰胆管造影术(ERCP)术后胰腺炎(PEP)中的水平变化,分析对比PCT、C反应蛋白(CRP)在PEP早期诊断中的临床价值。方法选择2010年6月至2017年2月行ERCP诊疗胆道结石患者120例。根据COTTON等专家组制定的ERCP术后并发症的定义的共识意见分为PEP组及对照组。实施ERCP诊疗患者术后2 h、6 h、24 h及48 h空腹采血样标本分别行PCT、CRP、血淀粉酶检测。PCT采用双抗体夹心免疫发光法检测,CRP浓度采用快速免疫透射比浊法。采血前未使用影响免疫功能的药物。结果术后24 h内各时间点两组患者的PCT、CRP水平均逐渐增高(P<0.001),且PEP组患者的PCT、CRP水平均高于对照组(P<0.001),PCT值在24 h达到峰值,后逐渐降低。对于两个指标,分组和时间均存在交互作用(P<0.001)。结论PCT、CRP均可作为PEP的独立预测指标,PCT在PEP选择治疗方法和手术时间上提供了更有价值的实验依据,检测方法简单易行、无创,患者及家属易于接受,值得临床推广应用。Objective To investigate the changes of levels in serum procalcitonin（PCT） in pancreatitis（PEP） after endoscopic retrograde cholangiopancreatography（ ERCP）,and to compare the clinical value of PCT and C-reactive protein（CRP） in the early diagnosis of PEP.Methods From June,2006 to February,2017,120 patients with biliary calculi were treated with ERCP in our hospital. According to consensus opinion on the definition of postoperative complications of ERCP developed by COTTON and other experts,they were divided into PEP group and control group.And then PCT,CRP and serum amylase were detected in 2 h,6 h,24 h and 48 h fasting blood samples after ERCP diagnosis and treatment.PCT was detected by double antibody sandwich immuno-luminescence method,and CRP concentration by rapid immune transmission turbidimetric method.No drugs that affected immune function were used before blood collection.Results 24 h after operation,the levels of PCT and CRP in the two groups gradually increased at each time point（ P〈0.001）,and those the PEP group were higher than those of the control group（ P〈0.001）,the PCT value reached the peak at 24 h and then decreased gradually. There was interaction between grouping and time in the two above-mentioned indexes（ P 〈 0. 001）. Conclusion PCT and CRP can be used as independent predictors of PEP.PCT provides a more valuable experimental basis for the choice of treatment methods and operation time of PEP.The detection method is simple and noninvasive,and the patients and their families are easy to accept,so it is worthy of clinical application.

关 键 词：ERCP术后胰腺炎 前降钙素 C反应蛋白 

分 类 号：R573[医药卫生—消化系统]