PCT、DD和MPV检测在重度急性胰腺炎中的临床价值  

Roles of PCT,DD and MPV determinations in severe acute pancreatitis

作　　者：刘守珠[1] 赵海明 LIU Shouzhu;ZHAO Haiming(Department of Clinical Laboratory,Qinghai Red Cross Hospital,Xining 810000,Qinghai,China;Department of Gastroenterology,Qinghai Red Cross Hospital,Xining 810000,Qinghai,China)

机构地区：[1]青海红十字医院检验科,青海西宁810000 [2]青海红十字医院消化科,青海西宁810000

出　　处：《检验医学》2018年第7期622-625,共4页Laboratory Medicine

摘　　要：目的探讨降钙素原(PCT)、D-二聚体(DD)和血小板平均体积(MPV)检测在重度急性胰腺炎(SAP)早期诊断和疗效监测中的价值。方法选取AP患者75例,其中轻度急性胰腺炎(MAP)患者45例、SAP患者30例。分别测定所有患者治疗前和治疗后24 h、48 h、7 d的PCT、DD和MPV水平。采用受试者工作特征(ROC)曲线评价各指标的诊断效能和治疗前3种指标诊断SAP的敏感性、特异性、阳性预测值及阴性预测值。比较SAP患者治疗后24 h、48 h和7 d的疗效与各项指标的变化。结果 SAP组MPV、DD和PCT水平明显高于MAP组(P=0.000)。ROC曲线分析显示,PCT、DD和MPV诊断SAP的曲线下面积分别为0.929、0.856、0.936。PCT诊断SAP的敏感性为93.3%,特异性为80.0%;DD诊断SAP的敏感性为73.3%,特异性为80.0%;MPV诊断SAP的敏感性为70.0%,特异性为86.7%;三者联合检测任意1项阳性诊断SAP的敏感性达96.7%,三者联合检测均阳性诊断SAP的特异性达97.8%。SAP患者治疗后24 h﹑48 h和7 d,其MPV、DD和PCT水平逐渐降低(P<0.05)。结论 PCT、DD和MPV联合检测在SAP诊断和疗效监测方面有一定的临床应用价值。Objective To assess the roles of procalcitonin(PCT),D-dimer(DD)and mean platelet volume(MPV)for the early diagnosis and curative effect monitoring of severe acute pancreatitis(SAP).Methods A total of 75 patients with acute pancreatitis(AP)were enrolled,including 45 cases of mild acute pancreatitis(MAP)and 30 cases of SAP.The levels of PCT,DD and MPV were determined before treatment and after treatment for 24 h,48 h and 7 d.Receiver operating characteristic(ROC)curve was used for evaluating diagnostic effects.The sensitivities,specificities,positive predictive values and negative predictive values of PCT,DD and MPV for the diagnosis of SAP were evaluated before treatment.After treatment for 24 h,48 h and 7 d,the curative effects and the changes of PCT,DD and MPV in patients with SAP were evaluated and compared.Results The levels of PCT,DD and MPV were higher in SAP group than those in MAP group(P=0.000).ROC curves showed that the areas under curves were 0.929,0.856 and 0.936.The sensitivity and specificity of PCT determination were 93.3%and 80.0%,the sensitivity and specificity of DD determination were 73.3%and 80.0%,the sensitivity and specificity of MPV determination were 70.0%and 86.7%,respectively.The sensitivity of the combined determination of PCT,DD and MPV was 96.7%,and the specificity was 97.8%.After treatment for 24 h,48 h and 7 d,the levels of PCT,DD and MPV were decreased in patients with SAP(P<0.05).Conclusions The combined determination of PCT,DD and MPV plays a role in the diagnosis and curative effect monitoring of SAP.

关 键 词：降钙素原 D-二聚体 血小板平均体积 重度急性胰腺炎 

分 类 号：R446.1[医药卫生—诊断学]