急性胰腺炎患者D-二聚体和C-反应蛋白水平变化及其与MODS相关性研究

目的:研究D-二聚体(D-dimer)、C-反应蛋白(CRP)水平在急性胰腺炎(AP)向多器官功能障碍综合征(MODS)转化中的临床意义。方法:96例AP患者中轻症胰腺炎(MAP)60例,重症胰腺炎(SAP)36例,分为MODS组和非MODS组,于入院48 h内用免疫吸附法(ELISA)检测D-dimer,用免疫增强比浊法检测CRP水平。结果:SAP组的D-dimer、CRP水平高于MAP组(P﹤0.01),MODS组D-dimer、CRP水平高于非MODS组(P﹤0.01),出现3个以上脏器损害时,其死亡率明显高于2个脏器损害患者的死亡率(P﹤0.01)。结论:联合检测AP患者血清D-dimer和CRP水平有助于早期诊断MODS,评估AP患者的病情与预后,对防止疾病进展和降低死亡率具有指导意义。

Study of D-dimer and C-reactive protein level in patients with acute pancreatitis and its Correlation with MODS

Objective To discuss the clinical significance of D-dimer and C-reactive protein（ CRP）in the patients with AP and/or-multiple organ dysfunction syndrome（ MODS ）. Method Data of 96 the patients were collected. The level of D -dimerwasmeasured by ELISA,and CRP was detected by immuno-turbidimetricmethod with automatic biochemical analysis. Results The level of D-dimer and CRP were higher in the patients with SAP than in those MAP,there were statistically significant differences（P﹤0. 01）. The levels of D-dimer and CRP were significantly higher in patients with MODS than in those without MODS,there were statistically significant differences （P﹤0. 01）. when three or more organ dysfunctions,its death rate was significantly higher than the two organ dysfunctions of patients（P﹤0. 01）. Conclusion The measurement of D-dimer and CRP is helpful to the early diagnosis of MODS in the patients with AP. It can con-tribute to the severity and prognosis of AP,and it has directive significance in preventing disease progression and reducing death rate.