尿胰蛋白酶原激活肽和血清降钙素原联合检测在大鼠胰腺炎早期诊断的意义

目的:研究尿胰蛋白酶原激活肽(TAP)和血清降钙素原(PCT)联合检测在大鼠急性坏死性胰腺炎早期诊断中的意义。方法:将72只大鼠随机分为两组,分别用1.5%和5%牛磺胆酸钠经胰胆管逆行注射制备轻症胰腺炎(MAP)和重症胰腺炎(SAP)模型。每组再分为3个亚组,分别于制模后6、12及24小时收集试验鼠尿液,采用竞争性酶联免疫吸附试验法(ELISA)检测TAP;采用双抗夹心免疫发光法测血清PCT水平,然后处死大鼠,取其胰腺观察其组织病理学改变并评分。结果:两组大鼠在制模后6、12和24小时胰腺病理评分逐渐增加,SAP组胰腺病理评分明显重于MAP组(P<0.05),尿TAP和血清PCT水平也相应增高,尿TAP和血清PCT检测的ROC曲线下面积增加,敏感度、特异度以及阳性似然比增加。结论:尿TAP和血清PCT水平与大鼠胰腺炎的严重程度相关联,二者联合检测可以增加敏感度和特异度,提高阳性似然比。

Significance of detection of urinary trypsinogen activation peptides and serum procalcitonin in experimental serious acute pancreatitis in rats

Objective:To investigate the significance of detection of urinary trypsinogen activation peptides and serum procalcitonin in experimental serious acute pancreatitis in rats. Methods:Thirty-six SD rats were randomly allocated to two groups : group SAP with retrograde ductal infusion of 5 % sodium taurocholate; group MAP with retrograde ductal infusion of 1.5% sodium tauro-cholate. Animals in each group were killed 6h ,12h and 24h after infusion. Urinary TAP was determined by ELISA and serum procalcitonin by Immunoluminometric Assay. The histological severity of the pancreas was assessed by Rongione method. Results:The pathologic score of group SAP was significantly higher than that of group MAP(P<0.05). After infusion of sodium taurocholate, the pathologic score of pancreas of both groups increased gradually. So did the level of urinary TAP and serum PCT. When the time pushed on, the area under ROC curve of urinary TAP and serum PCT expanded gradually. Conclusion:The sensitivity, specificity and positive likeli-hood rate of combination detection increased in the application of early diagnosis in acute necrotic pancreatitis.