血、尿胰蛋白酶原激活肽对急性胰腺炎的诊断及严重程度判断价值

目的结合CT扫描结果，探讨血、尿胰蛋白酶原激活肽（TAP）对急性胰腺炎的早期诊断和严重程度判断的价值。方法65例急性胰腺炎患者按CT结果分为轻症急性胰腺炎（MAP）组42例和重症急性胰腺炎（SAP）组23例，取29例同期非胰腺炎的急腹症患者作为对照组。分别测定所有患者血、尿TAP。结果在入院后6、12、24h，SAP组血TAP浓度〉9．0nmol／L，MAP组血TAP浓度〈3．5nmol／L，SAP组与MAP组、对照组比较差异有统计学意义（P〈0．05）；在入院后6、12、24h，SAP组尿TAP中位浓度（102．8、78．2、52．3nmol/L）显著高于MAP组（32．5、28．7、25.6nmol／L）及对照组（12．6、12．2、11．5nmol／L），差异有统计学意义（P〈0．05）；在入院后3、5d各组间血、尿TAP浓度比较差异无统计学意义（P〉0．05）。结论早期动态监测血、尿TAP具有较高诊断及预测价值，有利于急性胰腺炎的早期诊治。

The value of serum and urine trypsinogen activation peptide in the diagnosis and severity predicting of acute pancreatitis

Objective To explore the value oftrypsinogen activation peptide （TAP） levels in blood plasma and urine in the diagnosis of acute pancreatitis at early stage and severity predicting combined with the CT results. Method Sixty-five patients with acute pancreatitis who scanned with enhanced CT were divided into mild acute pancreatitis （MAP） group and severe acute pancreatitis （SAP） group according to the CT results, 29 patients with acute abdomen except for acute pancreatitis were as control group. TAP levels in blood plasma and urine were measured in all patients. Results At the time of 6, 12 and 24 h after admission, the level of blood plasma TAP in SAP group （ 〉 9.0 nmol/L） was significantly higher than that in MAP group（ 〈 3.5 nmol/L）, there were significant differences between SAP group and MAP group or control group （P 〈 0.05）. And the median urinary TAP in SAP group （102.8, 78.2, 52.3 nmol/L）was significantly higher than those in MAP group （32.5, 28.7, 25.6 nmol/L）and control group（12.6, 12.2, 11.5 nmol/L）, there were significant differences among three groups （P 〈 0.05）. At the time of 3, 5 d after admission, there was no significant difference in TAP levels in blood plasma and urine among three groups （P 〉 0.05）. Conclusions Early dynamic detection of TAP levels in blood plasma and urine is of higher diagnostic value and predictive value for acute pancreatitis, which is of benefit in the early diagnosis and treatment of acute pancreatitis.