重症急性胰腺炎继发感染性胰腺坏死患者细胞间黏附分子-1、降钙素原、血清C反应蛋白的表达及临床意义  

Significances of ICAM-1,PCT and CRP in Severe Acute Pancreatitis Patients with Secondary Infectious Pancreatic Necrosis

作　　者：党晓燕[1] 丁新爱[1] 孙媛[1] DANG Xiao-yan;DING Xin-ai;SUN Yuan(Exnergeney Department,the Second Affiliated Hospital of Xi＇an Jiaotong U-niversity,Xi＇an 710004,China)

机构地区：[1]西安交通大学第二附属医院急诊科,西安710004

出　　处：《解放军医药杂志》2018年第8期54-57,共4页Medical & Pharmaceutical Journal of Chinese People’s Liberation Army

基　　金：陕西省科学技术研究发展计划项目[2016K05-03(14)]

摘　　要：目的探讨细胞间黏附分子-1(ICAM-1)、降钙素原(PCT)及血清C反应蛋白(CRP)在重症急性胰腺炎继发感染性胰腺坏死患者中的变化及意义。方法选择2015年3月—2017年3月西安交通大学第二附属医院接诊的98例重症急性胰腺炎为研究对象,根据患者是否发生感染性胰腺坏死分为感染组46例和非感染组52例。分析ICAM-1、PCT、CRP在继发感染性胰腺坏死中的变化及诊断价值。结果感染组ICAM-1、PCT、CRP及Ranson评分均明显高于非感染组(P<0.05)。经Pearson相关分析显示,ICAM-1、PCT、CRP与Ranson评分均呈正相关(r=0.251、0.223、0.270,P<0.05)。联合检测诊断效能高于ICAM-1、PCT、CRP单独检测(P<0.05),联合检测特异度、准确度显著高于ICAM-1、PCT、CRP单独检测(P<0.05)。结论 ICAM-1、PCT、CRP在继发感染性胰腺坏死患者中均升高,均与Ranson水平密切相关,且三者联合检测诊断准确度显著增高,可作为诊断继发感染性胰腺坏死的重要指标。Objective To investigate changes and significances of intercellular adhesion molecule-1 （ICAM-1） , procalcitonin （PCT） and C reaction protein （CRP） in severe acute pancreatitis patients with secondary infectious pancreatic necrosis. Methods A total of 98 patients with severe acute pancreatitis admitted during March 2015 and March 2017 were divided into infection group （n =46） and non-infection group （n 52） according to whether or not having secondary infectious pancreatic necrosis. Changes and diagnostic values of ICAM-1, PCT and CRP in pancreatitis patients with secondary infected pancreatic necrosis were analyzed. Results ICAM-1, PCT and CRP levels and RansoM scores in infection group were significantly higher than those in non-infection group （P 〈 0.05）. Pearson correlation analysis showed that ICAM-1, PCT and CRP expressions were positively correlated with RansoM score （r =0.251, 0. 223, 0. 270, P 〈0.05）. Efficacy by combined diagnosis was significantly higher than those by ICAM-1, PCT and CRP diagnosis only （P 〈 0.05） , and values of specificity and accuracy of ICAM-1, PCT and CRP combined detection were significantly higher than those by ICAM-1, PCT and CRP detection only （P 〈 0.05）. Conclusion ICAM-1, PCT and CRP in pa- tients with secondary infectious pancreatic necrosis have increased expressions, and they are closely related to Ransory lev- el, and combined detection may have significantly higher accuracy, and therefore it can be used as one of important inde- xes in diagnosis of severe acute pancreatitis patients with secondary infectious pancreatic necrosis.

关 键 词：重症急性胰腺炎 感染性胰腺坏死 细胞间黏附分子-1 降钙素原 C反应蛋白 

分 类 号：R576[医药卫生—消化系统]