血清淀粉样蛋白A、降钙素原及C反应蛋白在急性胰腺炎病程中的变化及意义

目的:观察急性胰腺炎患者血清淀粉样蛋白A(serum amyloid A protein,SAA)、降钙素原(procalci-tonin,PCT)和C反应蛋白(C-reactive protein,CRP)在急性胰腺炎早期病程中的变化,探讨SAA、PCT及CRP在急性胰腺炎其临床实用价值。方法:轻型急性胰腺炎(MAP)患者32例,重症胰腺炎(SAP)患者10例,动态检测入院时和入院后第1、3、5、7天血清SAA、PCT及CRP的水平,并均与42例健康对照组相互比较。结果:(1)急性胰腺炎患者各个不同时间点SAA、PCT及CRP均显著高于对照组。(2)其中CRP在入院后第3天达最高水平,随后逐步降低,第3天后两组差异显著;在MAP组于入院后第3天达峰值,随后显著下降并逐步恢复正常水平,而SPA组一直保持在较高的水平。(3)SAA于SAP组、MAP组均在入院后第1天为最高水平,随后逐步降低,各时间点与第1天比较,差异显著。(4)PCT在SAP组入院后第1天、3天为最高水平,在MAP组第1天为最高水平,随后均逐步降低,各时间点与第1天比较,差异显著。结论:血清SAA、PCT及CRP水平的变化反应了急性胰腺炎患者病情严重程度,其中SAA和PCT对急性胰腺炎早期病程判断具有一定的临床意义。

Dynamic changes of Serum Amyloid A,Procalcitonin and C-Reactive Protein and the clinical significance during the the early process of acute pancreatitis

Objective To explore the dynamic changes and value of the serum amyloid A protein,procalcitonin and C-vreactive protein during the early process of acute pancreatitis.Methods 42 patients were divided into two groups: mild acute pancreatitis(n=32) and severe acute pancreatitis(n=10).All patients were employed for measuring the serum levels of SAA,PCT and CRP in patients on days 1,3,5,7 of onset of acute pancreatitis,42 health volunteers were enrolled as control group.Results(1) SAA,PCT and CRP levels in patients with acute pancreatitis were significantly higher than those in control group.(2) The levels of CRP of two groups reached the peak in day 3,and there was no difference in 3 days,But there was difference between MAP and SPA group after days 3.(3) the peak serum level of SAA in both SAP and MAP groups occurred on day 1,decreased with the treatment.(4) PCT level reached the peak in day 1 and day 3 for SAP group,day 1 for MAP group respectively,decreased with the treatment as well.Conclusion The changes of serum SAA,PCT and CRP levels manifest positive correlations to the severity of the condition of the patients with acute pancreatitis,serum SAA and PCT level can be more informative than serum CRP level in evaluating the changes of the conditions in early acute pancreatitis.