血清淀粉酶、脂肪酶与C反应蛋白联合检测在急性胰腺炎早期诊断中的应用价值

目的探讨血清淀粉酶(AMY)、脂肪酶(LPS)与C反应蛋白(CRP)联合检测在急性胰腺炎早期诊断中的应用价值。方法选择2016年8月至2018年8月我院收治的65例急性胰腺炎患者(急性胰腺炎组)及40例非急性胰腺炎的急腹症患者(非急性胰腺炎急腹症组)为研究对象,另选择同期80名健康者作为对照组。测定三组血清AMY、LPS及CRP水平,并绘制ROC曲线,评估AMY、LPS及CRP水平对急性胰腺炎早期诊断的效能。结果急性胰腺炎组及非急性胰腺炎急腹症组血清AMY、LPS及CRP水平均显著高于对照组,且急性胰腺炎组血清AMY、LPS水平显著高于非急性胰腺炎急腹症组,差异均具有统计学意义(P<0.05)。不同程度急性胰腺炎患者血清AMY、LPS水平比较,差异无统计学意义(P>0.05);重度急性胰腺炎患者CRP水平显著高于轻度急性胰腺炎患者,差异具有统计学意义(P<0.05)。AMY、LPS及CRP三者联合检测诊断效能最高,其灵敏度、特异度、准确度、阳性预测值及阴性预测值分别达90.8%、95.0%、93.5%、90.8%和95.0%。结论血清AMY、LPS及CRP水平检测是急性胰腺炎早期诊断的良好指标,三者联合检测能够有效提高急性胰腺炎早期诊断灵敏度、特异度和准确度,值得临床推广应用。

Application value of combined detection of serum amylase,lipase and C-reactive protein in early diagnosis of acute pancreatitis

Objective To explore the application value of combined detection of serum amylase(AMY),lipase(LPS)and C-reactive protein(CRP)in early diagnosis of acute pancreatitis.Methods From August 2016 to August 2018,65 patients with acute pancreatitis(acute pancreatitis group)and 40 acute abdomen patients without acute pancreatitis(non-acute pancreatitis acute abdomen group)treated in our hospital were selected as study objects,and 80 healthy persons in the same period were selected as control group.The levels of serum AMY,LPS and CRP were measured in the three groups,and the ROC curves were drawn to evaluate the efficacy of AMY,LPS and CRP levels detection in early diagnosis of acute pancreatitis.Results The levels of serum AMY,LPS and CRP in the acute pancreatitis group and the non-acute pancreatitis acute abdomen group were significantly higher than those in the control group,and the levels of serum AMY and LPS in the acute pancreatitis group were significantly higher than those in the non-acute pancreatitis acute abdomen group,and the differences were statistically significant(P<0.05).There were no significant differences in the levels of serum AMY and LPS in patients with different degrees of acute pancreatitis(P>0.05);the level of CRP in patients with severe acute pancreatitis was significantly higher than that in patients with mild acute pancreatitis,and the difference was statistically significant(P<0.05).The combined detection of AMY,LPS and CRP has the highest diagnostic efficiency and its sensitivity,specificity,accuracy,positive predictive value and negative predictive value were 90.8%,95.0%,93.5%,90.8%and 95.0%respectively.Conclusion The detection of serum AMY,LPS and CRP levels are good indicators for early diagnosis of acute pancreatitis,and the combined detection can effectively improve the sensitivity,specificity and accuracy of early diagnosis of acute pancreatitis,which is worthy of clinical promotion and application.