尿胰蛋白酶原-2快速检测在急性胰腺炎诊断中的价值

目的评估尿胰蛋白酶原2快速测定及尿淀粉酶／尿肌酐比值(U—amy／Ucr)对急性胰腺炎的诊断价值。方法对120例怀疑急性胰腺炎的急腹症患者进行血淀粉酶(B—amy)、尿淀粉酶(U—amy)、尿肌酐(Ucr)尿胰蛋白酶原2快速测定和B超检查。结果120例中53例确诊为急性胰腺炎(AP组)，其余67例则为其他原因导致的急腹症(非AP组)，40例为正常对照组。B—amy对急性胰腺炎的诊断敏感度为79．2％(分界值为125U／L)，特异性为76．1％；U-amy的敏感性为81．1％(分界值为490U／L)，特异性为73．1％；U—amy／Ucr的敏感性为94．4％，特异性为89．7％；尿胰蛋白酶原2试纸条法的敏感性为94．3％，特异性为95．5％；B超检查的敏感性为88．9％。结论对急性胰腺炎的诊断，U—amy／Ucr的敏感性和特异性较U—amy高，尿胰蛋白酶原2试纸条法的敏感性和特异性优于B-amy。

The value of diagnosis in acute pancreatitis by determined urinary trypsinogen-2 method

Objective To evaluate the diagnosis value of ratio of urinary amylase to urinary creatinine and urinary trypsinogen-2 in patients with acute pancreatitis(AP).Methods A total of 120 patients who were suspected as AP presenting with abdominal pain at the emergency department experienced the test of serum and urinary amylase,urinary creatinine assay,urinary trypsinogen-2 and ultraso-nography.Results There were 53 patients diagnosed as acute pancreatitis(AP group);67 patients diagnosed as non acute pancreatitis(non AP group);40 cases with normal control group.The serum amylase assay had a sensitivity of 79.2 percent(cut off value,125U per liter) and a specificity of 76.1 percent,the sensitivity and specificity of the urinary amylase assay and the ratio of urinary amylase to urinary creatinine were 81.1(cut offvalue,490U liter),73.1,94.4 and 89.7 percent,respectively.The sensitivity and specificity of the urinary trypsinogcw-2 test strip were 94.3 and 95.5 percent.The sensitivity of the ultrasonography was 88.9 percent.Conclusion Urinary trypsinogen-2 test is a good index for the diagnosis of AP.The ratio of urinary amylase to urinary creatinine is also an useful index and may be better than urinary amylase for the diagnosis of AP.