同型半胱氨酸、D-二聚体与急性胰腺炎严重程度的相关性研究  

Relationship between Acute Pancreatitis Severity and Serum Level of Homocysteine and D-dimer

作　　者：曾昭伟[1] 薛海玲[1] 陈淑莲 常艳敏[1] ZENG Zhao-wei;XUE Hai-ling;CHEN Shu-lian(Tianjin Nankai Hospital,Tianjin(300100),China)

机构地区：[1]天津市南开医院,天津300100

出　　处：《中国中西医结合外科杂志》2020年第6期1062-1066,共5页Chinese Journal of Surgery of Integrated Traditional and Western Medicine

基　　金：天津市卫生健康委、天津市中医药管理局中医、中西医结合科研项目(2019043)。

摘　　要：目的:探讨同型半胱氨酸(Hcy)、D-二聚体(D-dimer)与急性胰腺炎(AP)严重程度的相关性。方法:选取2018年10月—2020年7月天津市南开医院住院和门诊收治的AP患者87例,根据病情严重程度分为轻度AP48例、重度AP组39例;选取同期健康体检者50例为对照组,检测各组的血清Hcy和D-dimer水平并进行比较,采用受试者工作特征曲线(ROC曲线)分析Hcy、D-dimer对AP病情严重程度的预测价值。结果:AP组患者的血清Hcy、D-dmier水平明显高与对照组,差异有统计学意义(P<0.01),87例AP患者的血清Hcy和D-dmier的阳性率为71.26%、58.62%。AP组患者血清Hcy、D-dimer阳性率高于CON组,差异有统计学意义(P<0.001)。SAP组与MAP组患者的血清Hcy、D-dmier阳性率差异无统计学意义。Hcy、D-dmier的受试者工作特征曲线下面积(AUC)分别为0.956、0.722,差异有统计学意义,Hcy诊断AP的敏感度为92.0%,特异度为92.0%,分别高于D-dmier的78.2%及68.2%,差异有统计学意义(P<0.01)。Hcy检测对AP早期预测及严重程度评估的价值优于D-dmier检测。结论:AP患者Hcy和D-dmier水平高于对照组,且随着疾病严重程度的加深而增高,Hcy检测诊断AP的临床价值优于D-dmier检测。Objective To explore the relationship between acute pancreatitis severity and serum level of homocysteine and D-dimer.Methods Samples of87 patients with acute pancreatitis were collected from October 2018 to July 2020 in Tianjin Nankai Hospital.According the severity of acute pancreatitis,we divided these patients into two groups including 48 mild acute pancreatitis patients and 39 severe acute pancreatitis patients.Serum homocysteine and D-dimer levels were measured in 87 patients with acute pancreatitis and 50 normal healthy individuals.All biomarkers were measured and used for comparisons between groups.Using the receiver operating characteristic curve(ROC)analysis of the Hcy,D-dimerrespectively,we predict the value of the severity of the AP condition and the combined value of the AP disease.Results Compared with the control group,the serum levels of homocysteine and D-dimer in87patients with acute pancreatitis were higher,and the difference was statistically significant(P<0.01).The positive rates of serum homocysteine and D-dimer in 87patients with acute pancreatitis were 71.26%and 58.62%.The positive rates of Hcy and D-dimer in AP group were higher than those in CON group(P<0.001).There was no significant difference in the positive rates of Hcy and D-dmier between SAP group and MAP groups.The area under the receiver operating characteristic curve(AUC)for Hcy and D-dimer were 0.956 and 0.722respectively.The sensitivity and specificity of Hcy in the diagnosis of AP were 92.0%and 92.0%respectively,which were higher than 78.2%and 68.2%of D-dimer(P<0.01).Hcy detection is superior to D-dimer in early prediction and severity assessment of AP.Conclusion The level and positive rate of homocysteine and D-dimer in patients with acute pancreatitis are higher than those in normal healthy people,which increasing with the severity of the disease.The Hcy detection value was better than D-dimer.

关 键 词：同型半胱氨酸 D-二聚体 急性胰腺炎 

分 类 号：R657.5+1[医药卫生—外科学]