降钙素原在评价急性胰腺炎严重程度和早期预测中的意义

目的 回顾性分析研究降钙素原浓度与急性胰腺炎严重程度的关系以及是否有早期预测作用。 方法 选择100例急性胰腺炎(acute pancreatitis,AP)患者，按病情分为轻症组(即轻型胰腺炎，mild acute pancreatitis,MAP)和重症组(即重症急性胰腺炎，severe acute pancreatitis,SAP)，健康体检者10名作为对照组。测定患者入院第1、3、5、7天降钙素原(procalcitonin，PCT)浓度、24 h内APACHEⅡ评分(acute physiologyand chromc health evaluation，APACHEⅡ)、住院时间、统计学分析、处理相关数据，判断其与急性胰腺炎严重程度的关系。 结果 PCT重症组在1、3、5、7天与轻症组、对照组差异均有统计学意义(P＜0.05),而轻症组与对照组比较差异无统计学意义。APACHEⅡ评分轻症、重症组差异有统计学意义，住院时间2组间差异无统计学意义。采用Logistic回归分析结果显示PCT (PCT1、PCT3、PCT7)是发生重症急性胰腺炎的危险因素。PCT1的相对危险度(OR值)10.558，Exp (B)的95%CI下限2.109，上限52.847。 结论 重症急性胰腺炎PCT浓度明显升高或者持续高于正常，PCT浓度对于SAP有一定的预测作用:24 h内PCT浓度明显升高提示为SAP。 

Role of procalcitonin in evaluation of the severity of acute pancreatitis and the early prediction

Objective To analyze the correlation of procalcitonin(PCT) level and severity of acute pancreatitis(AP),and discuss its role in the early prediction of AP. Methods Total 100 cases of AP were enrolled and divided into mild acute pancreatitis group(MAP group) and severe acute pancreatitis group(SAP group),10 healthy subjects were recruited as controls at the same period.The levels of PCT at d1,d3,d5 and d7 after the admission were tested.The acute physiology and chronic health evaluation(APACHE Ⅱ) was performed in all patients within 24 hours.The duration of hospital stay was recorded.The results were analyzed statistically to evaluate the relationship between PCT level and severity of AP. Results The levels of PCT at d1,d3,d5 and d7 in SAP group were significant different from those in MAP and control group(P<0.05),but the difference was not significant between MAP group and control group(P>0.05).There were significant difference in APACHE Ⅱ score,but not in length of stay,between MAP and SAP group.Binary Logistic regression analysis showed that PCT(PCT1,PCT3 and PCT7) level was the risk factor for AP.The odds ratio(OR) for PCT1 were 10.558.The calculated the upper and lower limits were 52.847 and 2.109 at 95%CI for Exp(B). Conclusion The elevated or sustained PCT high level in SAP patients prompts that PCT level play an important role in the early(24 hours) prediction of SAP.