血清CRP与PCT及脂肪酶对重症急性胰腺炎患者发生感染性胰腺坏死的预测  

Predictive effect of serum CRP,PCT and lipase on infectious pancreatic necrosis in patients with severe acute pancreatitis

作　　者：杨珠莹[1] 谢齐贵[1] 陈湛蕾 朱世峰 夏亮[1] YANG Zhu-ying;Xie Qi-gui;CHEN Zhan-lei;ZHU Shi-feng;XIA Liang(Tongde Hospital of Zhejiang Province, Hangzhou, Zhejiang 310012, China)

机构地区：[1]浙江省立同德医院消化内科,浙江杭州310012

出　　处：《中华医院感染学杂志》2018年第11期1693-1696,共4页Chinese Journal of Nosocomiology

基　　金：浙江省中医药科技计划基金资助项目(2017ZA029)

摘　　要：目的探讨血清C-反应蛋白(CRP)、降钙素原(PCT)和脂肪酶含量对预测重症急性胰腺炎患者发生感染性胰腺坏死的意义。方法选取2012年1月-2017年1月于医院接受治疗的重症急性胰腺炎患者176例,根据是否发生感染性胰腺坏死,将患者分为感染组64例与非感染组112例,两组患者均接受禁水禁食、胃肠减压等综合内科治疗,患者于第1天和第7天抽取静脉血,检测血清CRP、PCT和血脂肪酶含量及其他检验指标:白细胞计数、血红蛋白(hemoglobin,Hb)、白蛋白(albumin,Alb)和血淀粉酶(AMS);同期选取100名健康体检人为对照组,比较三组研究对象血清CRP、PCT和血脂肪酶含量。结果健康体检人群血清CRP、血清PCT和血脂肪酶含量分别为(2.41±0.69)mg/L、(0.04±0.01)ng/ml和(172.71±73.94)U/L,重症急性胰腺炎患者第1天和第7天血清CRP、PCT和血脂肪酶含量分别为(42.74±10.26)mg/L、(3.27±1.64)ng/ml和(452.56±137.63)U/L,(169.35±53.27)mg/L、(10.58±4.23)ng/ml和(647.39±175.82)U/L,重症急性胰腺炎患者以上指标与对照组比较,差异有统计学意义(P<0.05);第1天和7天两个时间点处,感染组患者CRP、PCT和血清脂肪酶含量高于非感染组患者体内含量,差异有统计学意义(P<0.001);感染组患者白细胞计数、血红蛋白、白蛋白和血淀粉酶含量分别为(13.84±4.21)×109/L、(113.96±13.53)g/L、(36.21±4.39)g/L和(702.63±175.83)U/L与非感染组与感染组差异无统计学意义。结论重症急性胰腺炎发生感染性胰腺坏死时,血清CRP、PCT和血脂肪酶含量水平会大幅度上升,其联合检测对重症急性胰腺炎患者发生感染性胰腺坏死具有预测价值。OBJECTIVE To investigate the significance of serum C-reactive protein（CRP）,serum procalcitonin（PCT）and lipase for the prediction of infective pancreatic necrosis in patients with severe acute pancreatitis.METHODS A total of 176 patients with severe acute pancreatitis from Jan.2012 to Jan.2017 in the hospital for treatment were selected,and the patients were divided into infection group（64 cases）and non-infection group（112 cases）according to whether the occurrence of infectious pancreatic necrosis as the standard.Two groups of patients received no water fasting,gastrointestinal decompression and other comprehensive medical treatment.On the first day and the seventh day,venous blood of patients were taken for detection of serum C reactive protein（CRP）,procalcitonin（PCT）and lipase content,and other test indicators were detected,including white blood cell count,hemoglobin（Hb）,albumin（Alb）and serum amylase（AMS）.At the same time,100 healthy people were selected as the control group,and the serum CRP,PCT and lipase of the three groups were compared.RESULTS The serum levels of CRP,PCT and lipase of healthy people were（2.41±0.69）mg/L,（0.04±0.01）ng/ml and（172.71±73.94）U/L,respectively.On the first day and the seventh day,the serum CRP,PCT and lipase levels in severe acute pancreatitis patients were（42.74±10.26）mg/L,（3.27±1.64）ng/ml and（452.56±137.63）U/L,（169.35±53.27）mg/L,（10.58±4.23）ng/ml and（647.39±175.82）U/L,respectively,and there were significant differences between the healthy people and the severe acute pancreatitis patients（P〈0.05）.On the first day and the seventh day,the serum CRP,PCT and lipase content in infection group were higher than those in noninfection group,and there were significant differences between non-infection group and infection group（P〈0.001）.The white blood cell count,hemoglobin,albumin and blood amylase content in infection group were（13.84±4.21）×109/L,（113.96±13.53）g/L,（36.21±4.39）g/L an

关 键 词：C-反应蛋白 血清降钙素原 血脂肪酶 胰腺坏死 预测价值 

分 类 号：R576[医药卫生—消化系统]