联合PCT、钙离子、CRP及脂肪酶检测预测急性胰腺炎严重程度  

The value of PCT,calcium,CRP and lipase in predicting the severity of acute pancreatitis

作　　者：黄锐[1] 刘念[1] HUANG Rui;LIU Nian(Department of Critical Care Medicine,The First Affiliated Hospital of Anhui Medical University,Hefei 230022,China)

机构地区：[1]安徽医科大学第一附属医院重症医学科,合肥230022

出　　处：《肝胆外科杂志》2019年第6期422-425,共4页Journal of Hepatobiliary Surgery

摘　　要：目的探讨降钙素原(procalcitonin,PCT)、钙离子、C反应蛋白(C-reactive protein,CRP)、脂肪酶与急性胰腺炎(acute pancreatitis,AP)患者病情严重程度的相关性,评价单项及联合检测各指标在评估AP严重程度方面的价值。方法回顾性分析2017年4月至2019年4月安徽医科大学第一附属医院收治的142例AP患者的临床资料,根据患者病情严重程度分为轻症急性胰腺炎组(MAP)71例、重症急性胰腺炎组(SAP)71例,入院24h内均测PCT、钙离子、CRP、脂肪酶水平。结果入院24h内SAP患者PCT、CRP、脂肪酶水平显著高于MAP组,钙离子明显低于MAP组(P<0.05);Spearman相关分析提示,在MAP组PCT、钙离子与病情严重程度呈相关性(r:0.291、-0.245,P<0.05),在SAP组PCT、钙离子、脂肪酶与病情严重程度呈相关性(r:0.607、-0.604、0.236,P<0.05);PCT、钙离子、CRP、脂肪酶预测SAP的临界值分别为(0.62 ng/ml.2.07 mmol/L.68.05 mg/L.338 u/L),根据此临界值单相项检测PCT及钙离子具有较理想的灵敏度和特异度,联合检测中PCT联合钙离子灵敏度和特异度均较高。结论PCT、钙离子、CRP、脂肪酶可有效评估AP患者病情严重程度,PCT、钙离子是SAP的最佳预测因子,联合检测可提高预测SAP的灵敏度。Objective To explore the correlation between procalcitonin(PCT),calcium ion,c-reactive protein(CRP)and lipase and the severity of acute pancreatitis patients,and evaluate the value of individual and combined detection indexes in assessing the severity of AP.Methods The clinical data of 142 AP patients admitted to the first affiliated hospital of Anhui medical university from April 2017 to April 2019 were retrospectively analyzed.According to the severity of their condition,71 patients were divided into mild acute pancreatitis group(MAP)and severe acute pancreatitis group(SAP).PCT,calcium,CRP and lipase levels were measured within 24 hours after admission.Results Within 24 hours after admission,PCT,CRP and lipase levels of SAP patients were significantly higher than those of MAP group,and calcium ions were significantly lower than those of MAP group(all P<0.05).Spearman correlation analysis showed that PCT,calcium ion and severity of the disease were correlated in the mild group(r:0.291,-0.245,P V0.05),while PCT,calcium ion and lipase were correlated in the severe group(r:0.607,-0.604,0.236,P V0.05).The critical values of PCT,calcium ion,CRP and lipase for SAP prediction were(0.62ng/ml s2.07mmol/L、68.05mg/L、338u/L),respectively.According to this critical value,single-phase detection of PCT and calcium ion had relatively ideal sensitivity and specificity,and PCT combined with calcium ion had higher sensitivity and specificity in the combined detection.Conclusion PCT,calcium ion,CRP and lipase can effectively evaluate the severity of the condition of AP patients,and PCT and calcium ion are the best predictors of SAP,and combined detection can improve the sensitivity of predicting SAP.

关 键 词：急性胰腺炎 严重程度 预测价值 

分 类 号：R659[医药卫生—外科学]