血清降钙素原在急性胰腺炎危重度早期评估中的价值研究

目的 降钙素原(PCT)作为严重细菌感染的早期诊断指标,是反映机体感染程度的一个生物学指标,可对细菌感染进行预测判断。本研究通过检测血清降钙素原探讨其对急性胰腺炎(AP)严重程度的早期诊断价值。 方法 收集AP患者109例,其中重症急性胰腺炎(SAP)41例,轻型急性胰腺炎(MAP)68例,50例健康体检人群空腹血清PCT和CRP为对照,分别在入院后第1、3、5、7天动态监测患者PCT和CRP水平,分析这些指标与AP严重程度及预后关系,采用SPSS 17.0统计软件对数据进行处理。 结果 MAP组和SAP组患者血清PCT和CRP水平均高于对照组(P<0.05),除第1天血清CRP外,其余SAP组患者同期PCT和CRP水平均高于MAP组(均P<0.05)。以2.0μg/L和120.0 mg/L分别为诊断SAP血清PCT和CRP阳性阈值,血清PCT和CRP诊断SAP的灵敏度分别为82.9%和70.7%,特异度均达90%以上,PCT和CRP联合检测则发现灵敏度提高到92.7%,而特异度仍达90%以上。 结论 血清PCT能够在早期反映急性胰腺炎患者的病情严重程度,有一定的临床指导价值。以2.0μg/L和120 mg/L分别为诊断SAP血清PCT和CRP阳性阈值,血清PCT诊断SAP具有很好的灵敏度和特异度。 

The clinical value of the procalcitonin in prediction of severity of acute pancreatitis

Objective Procalcitonin (PCT) is a biomarker of early bacterial infection, and it can reflect severity of infection, and regarded as a prognostic factor.In this study, PCT was used to evaluate the clinical value of serum procalcitonin (PCT) in early diagnosis of acute pancreatitis (AP) and predictive of severity. Methods The enrolled included 41 cases of the severe AP (SAP), 68 cases of mild AP (MAP), and 50 cases of normal controls.The levels of PCT and CRP in each group were dynamically detected respectively at 1st, 3th, 5th and 7th day after admission, and the correlations between these indexes and the severity and progress of AP were analyzed and data were processed by statistical software SPSS17.0. Results The levels of serum PCT and CRP in SAP and MAP patients were significantly higher than those of control group (all P < 0.05).In addition to 1st of serum CRP, the rest of S PCT and CRP levels in patients with SAP group were higher than those in the same period of MAP group (all P < 0.05).The threshold of PCT and CRP in SAP were 2.0μg/L and 120 mg/L, respectively.The sensitivity of the serum PCT and CRP were 82.9% and 70.7%, respectively;the specificity of the serum PCT and CRP were all above 90%.The serum PCT + CRP combined detection of sensitivity enhanced to 92.7% and specificity still above 90%. Conclusion Serum levels of PCT can reflect the severity of acute pancreatitis at the early stage and has an important clinical value.When the levels of PCT and CRP reach the cut-off values of2.0 μg/L and 120 mg/L, serum PCT value is a sensitive and specific serological a diagnostic method for diagnosis of SAP.