血清sFlt-1、CRP和AMY联合检测在重症急性胰腺炎早期诊断中的价值探讨  

Value of combined detection of serum sFlt-1,CRP and AMY in the early diagnosis of severe acute pancreatitis

作　　者：王利公[1] 赵珊[1] 白凯 张宁[1] 张楠 刘军辉[1] WANG Ligong;ZHAO Shan;BAI Kai;ZHANG Ning;ZHANG Nan;LIU Junhui(Laboratory Department,First Affiliated Hospital of Xi′an Jiaotong University,Xi′an Shanxi 710061,China)

机构地区：[1]西安交通大学第一附属医院检验科,陕西西安710061

出　　处：《中国急救复苏与灾害医学杂志》2021年第11期1249-1251,1307,共4页China Journal of Emergency Resuscitation and Disaster Medicine

基　　金：陕西省科学技术研究发展计划项目(编号:2016SF-217)。

摘　　要：目的探讨血清可溶性fms样酪氨酸激酶1(soluble fms-like tyrosine kinase 1,sFlt-1)、C反应蛋白(C reac⁃tive protein,CRP)和淀粉酶(amylase,AMY)联合检测在重症急性胰腺炎(severe acute pancreatitis,SAP)早期诊断中的价值。方法选取2019年3月-2021年2月西安交通大学第一附属医院收治的146例急性胰腺炎(AP)患者为研究对象,其中SAP患者84例(研究组)、轻症急性胰腺炎(mild acute pancreatitis,MAP)患者62例(对照组)。对比两组临床特征,分析影响SAP发生的因素,以受试者工作特征(ROC)曲线下面积(AUC)评估血清sFlt-1、CRP和AMY联合检测对SAP早期诊断的价值。结果研究组空腹血糖(fasting plasma glucose,FPG)、白细胞、总胆固醇(total cholesterol,TC)、脂肪酶、CRP、sFlt-1、AMY水平均高于对照组(P<0.05)。Logistic回归多因素分析显示CRP、sFlt-1、AMY是SAP发生的影响因素(P<0.05)。ROC曲线分析显示血清sFlt-1、CRP、AMY及三者联合对SAP诊断的AUC分别为0.803(95%CI:0.711~0.895)、0.793(95%CI:0.687~0.898)、0.791(95%CI:0.691~0.891)、0.894(95%CI:0.830~0.959)。结论SAP患者存在CRP、sFlt-1、AMY水平过高现象,CRP、sFlt-1联合AMY对早期诊断SAP具有较高诊断价值。Objective To explore the value of combined detection of serum soluble fms-like tyrosine kinase 1(sFlt-1),C-reactive protein(CRP)and amylase(AMY)in the early diagnosis of severe acute pancreatitis(SAP).Methods 146 patients with acute pancreatitis(AP)admitted to the First Affiliated Hospital of Xi′an Jiaotong University from March 2019 to February 2021 were selected as the research object.84 with moderate SAP(study group)and 62 with mild acute pancreatitis(MAP)(control group)to test the fasting plasma glucose(FPG),triglyceride(TG),total cholesterol(TC),high density lipoprotein cholesterol(HDLC),low density lipoprotein cholesterol(LDLC),lipase,adipokinase,creatine(Cre),urea nitrogen(BUN),white blood cells(WBC),hemoglobin(Hb),and serum sFlt-1 by ELISA,CRP by immunoturbidimetry,and AMY by performance rate method.The clinical characteristics of the two groups were compared,the factors affecting the occurrence of SAP were analyzed,and the area under the receiver operating characteristic(ROC)curve(AUC)was used to evaluate the value of combined detection of serum sFlt-1,CRP and AMY in the early diagnosis of SAP.Results The levels of FPG,WBC,TC,lipase,CRP,sFlt-1 and AMY in the study group were all significantly higher than those in the control group(all P<0.05).Logistic regression multivariate analysis showed that CRP,sFlt-1,and AMY were the influencing factors of the occurrence of SAP(all P<0.05).ROC curve analysis showed that the AUC of serum sFlt-1,CRP,AMY and the combination of the three for the diagnosis of SAP were 0.803(95%CI:0.711~0.895),0.793(95%CI:0.687~0.898),0.791(95%CI:0.691~0.891),and 0.894(95%CI:0.830~0.959)respectively.Conclusion SAP patients have high levels of CRP,sFlt-1,and AMY.The combination of CRP,sFlt-1 and AMY has a high diagnostic value for early diagnosis of SAP.

关 键 词：可溶性fms样酪氨酸激酶1 C反应蛋白 淀粉酶 重症急性胰腺炎 诊断 

分 类 号：R725.6[医药卫生—儿科]