sICAM-1和PCT在急性胰腺炎诊治中的临床价值

目的：探讨细胞间黏附分子-1（sICAM-1）和降钙素原（PCT）水平在急性胰腺炎（AP）发病中的作用及诊断意义。方法：将77例急性胰腺炎（AP）患者分为轻型急性胰腺炎（MAP）31例,重症型急性胰腺炎（SAP）46例,并对SAP按有无感染分为SAP-1（感染性）25例和SAP-2（非感染性）21例;分别取其7d内的空腹静脉血,用ELISA测定血清sICAM-1水平,用双抗体夹心化学发光法测定血清PCT水平,并与正常对照组进行比较。结果：SAP-1和SAP-2组的sICAM-1水平高于MAP组,差异有统计学意义（P〈0.01）,所有的AP患者与正常对照组比较,也存在显著差异;SAP-1组的PCT水平与MAP组、SAP-2组和正常对照组比较,差异有统计学意义（P〈0.01）。结论：sICAM-1和PCT的水平变化与AP的发生、发展过程密切相关,认为其可以作为AP早期诊断及预后判断有价值的指标。

Clinical Value of Determination of Serum Soluble Inter Cellular Adhesion Molecule-1(sICAM-1) and Procalcitonin(PCT) Levels in Patients with Acute Pancreatitis

Objective To investigate the clinical value of determination of serum soluble inter cellular adhesion molecule-1（sICAM-1） and procalcitonin （PCT） levels in patients with acute pancreatitis （AP）. Methods Serum sICAM-1 （with ELISA） and procalcitonin （with CLIA） levels were determined within 7 days after onset of disease in ① 31 patients with mild acute pancreatitis （MAP） ② 25 patients with severe acute pancreatitis with in fection （SAP-1） ③ 21 patients with severe acute pancreatitis without infection （SAP-Ⅱ） and ④ 40 controls. Results Serum sICAM-1 levels in patients with severe pancreatitis were significantly higher than those mild pancreatitis （P0.01）. Serum sICAM-1 levels in patients with all types of pancreatitis were significantly higher than those in controls. Serum PCT levels in severe pancreatitis cases with infection （SAP-1） were significantly higher than those in all other groups （P0.01）. Conclusion Serum levels of sICAM-1 and PCT are closely related to the course of AP and can be taken as markers for early diagnosis and prognosis as well as for the classification of AP.