胰蛋白酶原激活肽和降钙素原早期诊断重症急性胰腺炎的价值

目的：研究尿胰蛋白酶原激活肽和血清降钙素原联合检测在重症急性胰腺炎早期诊断中的价值。方法：选取出现症状24h内入院的急性胰腺炎患者68例及对照组患者21例,留取入院时、24h、48h及72h尿样和血样,测定尿胰蛋白酶原激活肽（trypsinogen activation peptides,TAP）和血清降钙素原（procalcitonin,PCT）、淀粉酶和C反应蛋白,入院后72h按照病变程度分为重症组和轻症组。结果：急性胰腺炎组与非急性胰腺炎组各项检测结果均存在显著性差异（P〈0.05）,各检测指标的敏感度、特异性和阳性似然比存在一定差异,尿TAP和血清PCT在入院48h后统计效能最高,尿TAP敏感度、特异度以及阳性似然比分别为90.5%、87.5%和7.2;血清PCT敏感度、特异度及阳性似然比分别为90.5%、82.5%和7.2。结论：与其它检测指标相比,尿TAP和血清PCT在急性重症胰腺炎的早期有诊断价值。

Advantages of combination of urinary trypsinogen activation peptide and serum procalcitonin in the early detection of severe acute pancreatitis

Objectiv e：To evaluate the advantages of combination of urinary trypsinogen activation peptide and serum procalcitonin in the early detection of severe acute pancreatitis.Methods：61 acute pancreatitis patients within 24 h after the occurrences of syndrome were enrolled and 21 patients of other reasons were studied as controls.Urinary trypsinogen activation peptide,serum procalcitonin,amylase and C-reaction protein were determined immediately 24 h,48 h and 72 h.Acute pancreatitis patients were grouped as MAP and SAP after 72 h according to the clinical manifestations.Results：All the indexes were significantly higher in the AP group（P0.05）.Urinary trypsinogen activation peptide and serum procalcitonin were increased significantly after 48 h.The sensitivity、specificity and positive likelihood rate of TAP and PCT were 90.5%,87.5%,7.2 and 90.5%,82.5%,7.2 respectively.Conclusions：Combination of urinary trypsinogen activation peptide and serum procalcitonin was better than the other traditional indexes in early diagnosis of severe acute pancreatitis.