尿淀粉酶/尿肌酐及尿胰蛋白酶原-2诊断急性胰腺炎的评价

目的探讨尿淀粉酶/尿肌酐(Uamy/Ucr)及尿胰蛋白酶原2测定对急性胰腺炎的临床诊断价值。方法对79例急性胰腺炎患者、48例非胰腺炎急腹症患者和50例健康对照组人员进行血清淀粉酶(Samy)、尿淀粉酶(Uamy)、尿肌酐(Ucr)及尿胰蛋白酶原2测定。结果急性胰腺炎尿胰蛋白酶原2的诊断特异性最高,其特异性和敏感性分别为97.92%和91.14%,其次Uamy/Ucr特异性为91.67%,敏感性为92.41%(临界值为75U/mmol),而临床常用的诊断指标Samy、Uamy的特异性和敏感性均低于前两者。结论尿淀粉酶/尿肌酐比值及尿胰蛋白酶原2检测是较好的早期诊断急性胰腺炎的指标。

The clinical value of the ratio of urine amylase to urine creatinine assay and urinary trypsinogen-2 dipstick test in the diagnosis of acute pancreatitis

Objective To assess the clinical value of the ratio of urine amylase to urine creatinine and urine trypsinogen-2 dipstick test in the diagnosis of acute pancreatitis.Methods Serum amylase ,urine amylase ,urine creatinine and urine trypsinogen-2 in 79 patients with acute pancreatitis,48 patients with nonpancreatitis acute abdomen and 50 healthy controlled people were detected and compared.Results The urinary trypsinogen-2 test strip had a high sensitivity and specificity of 91.14% and 97.92% ,respectively. The sensitivity and specificity of the ratio of urinary amylase to urinary creatinine assay were 92.41% and 91.67% (cutoff value, 120 U per mmol Cr),which were also high. The sensitivity and specificity of the serum amylase assay and the urinary amylase assay were lower than those of the two aforementioned indexes.Conclusion The ratio of urine amylase to urine creatinie assay and urinary trypsinogen-2 test strip are useful and better than the traditional assays for the diagnosis of acute pancreatitis in the early stage.