尿胰蛋白酶原-2在不同人群中诊断胰腺炎的阳性预测值评价

目的 评价尿胰蛋白酶原-2(TPS-2)在不同人群中诊断胰腺炎的阳性预测值,避免因此导致的胰腺炎误诊.方法 筛选该院尿TPS-2阳性的门诊或住院患者136例作为研究对象,对其进行血液、尿液淀粉酶测定及胰腺部位CT扫描,按照<胰腺炎诊断标准>判断是否患有胰腺炎.根据有无急腹症、是否伴有淀粉酶升高两指标将研究对象分为不同人群,计算各组人群尿TPS-2诊断胰腺炎的阳性似然比及阳性预测值;按研究对象首诊疾病种类进行分类,分别计算各类疾病尿TPS-2诊断胰腺炎的阳性似然比及阳性预测值.结果 尿TPS-2诊断胰腺炎的阳性似然比及阳性预测值在急腹症人群分别为1.10和52.38%,其中胰腺炎主要集中在伴有淀

The evaluation on the positive predictive value of pancreatitis diagnosed by urine trypsinogen-2 in different groups

Objective To evaluate objectively the positive predictive value diagnosed pancreatitis of urine trypsinogen 2(TPS-2) in different groups,and avoid misdiagnosing pancreatitis only according to test result of urine TPS-2.Methods 136 cases clinic or hospital patients with positive result of urine TPS-2 were screened as research object.The amylase levels in blood and urine of the research object were detected,and pancreases of the research object were scanned by CT.The research object was diagnosed whether suffering pancreases or not according to diagnosis standard of pancreatitis.The research object was divided into different groups respectively according to abdominal pain symptoms,the measured value of amylase and primary diagnosed disease type.The positive likelihood ratio and positive predictive value of urine TPS-2 in these groups were calculated.Results The positive likelihood ratio and positive predictive value of urine TPS-2 in acute abdomen group were 1.10 and 52.38% respectively,whereas the positive likelihood ratio and positive predictive value in non acute abdomen group were 0.028 and 2.74% respectively.In the cancer group,the peptic ulcer group and the renal damage disease group,the positive likelihood ratio of urine TPS-2 were 0.03,0.00,0.02,and positive predictive value of urine TPS-2 were 2.00%,0.00%,2.94%,respectively.Conclusion There are significant difference in positive predictive value of urine trypsinogen 2 between different people group.We should consider prior probability of urine TPS-2 and other diagnosis markers of pancreatitis when pancreatitis is diagnosed according test result of urine TPS-2.