急性胰腺炎血清胰酶与胰腺微循环相关性的CT灌注研究  

CT Perfusion Study on the Relationship between Serum Trypsin and Pancreatic Microcirculation in Acute Pancreatitis

作　　者：陈钰莹 黄小华[1] 明兵[2] 唐玲玲 胡云涛 刘念[1] CHEN Yuying;HUANG Xiaohua;MING Bing(Department of Radiology,Affiliated Hospital of North Sichuan Medical College,Nanchong,Sichuan Province 637000,P.R.China)

机构地区：[1]川北医学院附属医院放射科,南充637000 [2]德阳市人民医院放射科,618000

出　　处：《临床放射学杂志》2023年第6期942-946,共5页Journal of Clinical Radiology

基　　金：南充市市校科技战略合作项目-主要研发平台基金资助项目(编号:19SXHZ0429);南充市市校科技战略合作基金资助项目(编号:20SXQT0303)。

摘　　要：目的 基于CT灌注成像(CTP)探讨急性胰腺炎(AP)状态下血清胰酶(血清淀粉酶及脂肪酶)与胰腺微循环的相关性。方法 回顾性搜集163例AP患者,按照血清胰酶的高低值分为三组:血清胰酶正常组47例(A组),血清胰酶至少一个升高但未升高达正常值三倍组50例(B组),血清胰酶至少一个升高达正常值三倍及以上组66例(C组)。所有病例均行胰腺CTP,将获得的灌注数据传至后处理工作站,用灌注软件包处理灌注数据,记录胰腺组织各灌注参数值[血流量(BF)、血容量(BV)、平均通过时间(MTT)及流量提取参数(FE)]并进行统计学分析;采用Spearman相关性分析血清胰酶与胰腺灌注参数的相关性;采用单因素方差分析比较三组间灌注参数的统计学差异。结果 Spearman相关性分析显示CT灌注参数BF、BV与血清胰酶呈正相关,相关系数(γ)分别为0.247、0.189。单因素方差分析示三组间的灌注参数BF、BV、MTT均有统计学差异(P<0.05),但三组间FE无统计学差异(P>0.05);SNK-q检验示A组与C组间的灌注参数BF、BV、MTT有统计学差异(P<0.05);B组与C组间的灌注参数BF、MTT有统计学差异(P<0.05),BV无统计学差异(P>0.05);A组与B组间的灌注参数BF、BV和MTT之间均无统计学差异(P>0.05)。结论 AP状态下血清胰酶与胰腺灌注量(BF及BV)呈正相关,血清胰酶升高,胰腺灌注量在一定程度上相对增加。Objective To investigate the correlation between serum trypsin(serum amylase and lipase)and pancreatic microcirculation in acute pancreatitis based on CT perfusion imaging.Methods 163 patients with acute pancreatitis were retrospectively collected and divided into three groups according to the high and low value of serum trypsin:47 patients in the group with normal serum amylase and lipase(group A),50 patients in the group with elevated serum amylase and lipase at least one but not three times the normal value(group B),at least one of serum amylase and lipase increased to three times the normal value in 66 cases(Group C).Pancreatic CT perfusion imaging was performed in all cases,and the perfu-sion data were transmitted to the post-processing workstation.The perfusion data were processed by perfusion software pack-age,and the perfusion parameters[blood flow(BF),blood volume(BV),mean transit time(MTT)and flow extraction pa-rameters(FE)] were recorded and statistically analyzed.Spearman correlation analysis was used to analyze the correlation between serum ptrypsin and pancreatic perfusion parameters.One-way ANOVA was used to compare the statistical differ-ences of perfusion parameters among the three groups.Results Spearman correlation analysis showed that CT perfusion parameters BF and BV were positively correlated with serum pancreatic amylase,lipase,=0.247 and 0.189 respectively.One-way ANOVA showed that there were significant differences in BF,BV,MTT among the three groups(P<O.05),but there was no significant difference in FE among the three groups(P>0.05).SNK-q test showed that there was significant difference in perfusion parameters BF,BV,MTT between group A and group C(P<0.05),BF,MTT and BV between group B and group C(P<0.05),and there was no significant difference in perfusion parameters BF,BV and MTT between group A and group B(P>0.05).Conclusion There is a positive correlation between serum trypsin and pancreatic blood perfusion in acute pancreatitis,pancreatic perfusion would increase with the increase o

关 键 词：急性胰腺炎 血清淀粉酶 脂肪酶 CT灌注成像 微循环 

分 类 号：R576[医药卫生—消化系统] R816.5[医药卫生—内科学]