淀粉酶、C反应蛋白及CT表现联合应用在急性胰腺炎的诊断价值

目的：探讨急性胰腺炎患者的血清、尿淀粉酶、C反应蛋白改变及CT表现的相关性。方法：回顾性分析已确诊的急性胰腺炎60例,将其CT改变分为五个级别,各级病例分别与相应的血清、尿淀粉酶及C反应蛋白值对比分析。结果：血、尿淀粉酶在轻、重症胰腺炎患者中无差别（P〉0.05）,而C反应蛋白值在重症胰腺炎中明显高于轻症胰腺炎（P〈0.05）。CT改变为A级时血、尿淀粉酶轻中度升高;B级时中度升高;C级时显著升高;D级时趋向下降;E级时显著下降。结论：CT检查可以准确地反映急性胰腺炎B,C,D,E级的病理变化,明显优于淀粉酶的改变,而对于早期间质水肿型的炎症,CT诊断困难,主要靠血、尿淀粉酶及C反应蛋白,其中C反应蛋白有助于判断急性胰腺炎病情严重程度。

Combination with Amylase, C-reactive protein and CT in the diagnosis of acute pancreatitis

Objective：To evacuate the serum and urine amylase, C-reactlve protein changes and CT findings in acute panereatitis. Methods： 60 cases with acute pancreatitis were divided into five grads based on CT findings and the CT grading relevant to the serum and urine amylase and C-reactive protein were analyzed. Results： serum and urine amylase in the MAP, no difference in patients with SAP （ P 〉 0. 05 ）, But C-reactive protein in SAP was significantly higher than in MAP （ P 〈 0. 05 ）. The serum and urine amylase increase slightly or moderately in grading A, moderately in grade B, markedly in grade C, but tended to decrease in grade D, and decreased dramatically in grade E. Conclusion： CT examination is superior to the serum and urine amylase in evaluation of acute panereatitis wide B, C, D and E. But for grade A, accurate diagnosis should be made based on CT findings combined with die changing of serum and urine amylase and C-reactive protein, C-reactive protein which help to determine the severity of acute pancreatifis.