CT严重指数、超声造影联合血清降钙素原评估AP疗效

背景超声具有无创简便等优点,在急性胰腺炎病诊治中发挥着重要作用,而超声造影能通过分析胰腺微循环血流灌注,评估其缺血坏死状态,为临床诊治提供血流动力学信息.目的探讨超声造影联合血清降钙素原(procalcitonin,PCT)在评估急性胰腺炎(acute pancreatitis,AP)病情和疗效中的应用价值,及其与CT严重指数(CT severity indices,CTSI)的相关性.方法选取在我院接受治疗的AP患者作为研究对象,共63例,其中轻症AP患者38例(轻症AP组),重症AP患者25例(重症AP组).所有患者治疗前后测定血清PCT水平,行胰腺超声造影及腹部多层螺旋CT检查,记录超声造影严重指数(ultrasound severity indices,USSI)及CTSI,分析超声造影联合PCT评估疗效的可行性.结果超声造影诊断轻症AP患者37例,重症AP患者26例,敏感度=92.00%(23/25),特异度=92.11%(35/38);准确率=92.06%(58/63);重症AP组的血清PCT水平、USSI及CTSI明显高于轻症AP组,差异均有统计学意义(P<0.05);不同治疗结局组间的血清PCT水平、USSI及CTSI比较,差异均有统计学意义(P<0.05);治疗后患者血清PCT水平、USSI分别与CTSI呈正相关(r=0.803,0.951,均P<0.05);治疗后患者血清PCT水平、USSI分别与临床疗效呈负相关(r=-0.721,-0.836,均P<0.05).结论超声造影能有效显示胰腺组织缺血坏死状态,准确反映AP病情,联合血清PCT水平可为临床全面准确评估AP病情及预后提供有价值的参考.

Contrast-enhanced ultrasound combined with serum procalcitonin for evaluating therapeutic efficacy for acute pancreatitis

BACKGROUND Ultrasound has the advantages of non-invasiveness and simplicity,and plays an important role in the diagnosis and treatment of acute pancreatitis.Contrast-enhanced ultrasound(CEUS)can analyze the pancreatic microcirculation blood perfusion and evaluate its ischemic necrosis status,providing hemodynamic information for clinical diagnosis and treatment.AIM To evaluate the clinical value of CEUS with serum procalcitonin(PCT)in evaluating the condition of and the curative effect in acute pancreatitis(AP),as well as its correlation with CT severity index(CTSI).METHODS Sixty-three patients with AP treated at our hospital were selected as the research subjects,including 38 patients with mild AP(mild AP group)and 25 with severe AP(severe AP group).Before and after treatment,serum PCT level was measured,pancreatic CEUS and abdominal multi-slice spiral CT were performed,and ultrasound severity index(USSI)and CTSI were recorded.The feasibility of evaluating the curative effect by CEUS combined with PCT was analyzed.RESULTS Thirty-seven patients with mild AP and 26 with severe AP were diagnosed by CEUS,which had a sensitivity of 92.00%(23/25),specificity of 92.11%(35/38),and accuracy of 92.06%(58/63).Serum PCT level,USSI,and CTSI in the severe AP group were significantly higher than those in the mild AP group(P<0.05).There were significant differences in serum PCT level,USSI,and CTSI among different treatment outcome groups(P<0.05).Serum PCT level and USSI were positively correlated with CTSI after treatment(r=0.803 and 0.951,respectively;P<0.05).Serum PCT level and USSI were negatively correlated with clinical efficacy after treatment(r=-0.721 and-0.836,respectively;P<0.05).CONCLUSION CEUS can effectively display the ischemic necrosis state of pancreatic tissue and accurately reflect the condition of AP.When combined with serum PCT level,CEUS can provide valuable reference for clinical comprehensive and accurate evaluation of the condition and prognosis of AP.