降钙素原和C反应蛋白在急性胆源性胰腺炎中的诊断及预后价值比较

Value of procalcitonin and C-reactive protein in early stage acute biliary pancreatitis

目的:比较血清降钙素原(procalcitonin,PCT)和C反应蛋白(C-reactive protein,CRP)在急性胆源性胰腺炎(acute biliary pancretitis,ABP)早期诊疗中的应用价值。方法:回顾性地收集2014年1月至2018年3月上海交通大学医学院附属瑞金医院收治住院的195例急性胰腺炎(acute pancretitis,AP)患者的相关资料,根据其病因分为ABP组和急性非胆源性胰腺炎组。其中,ABP组患者根据病情的严重程度进一步分为轻度ABP(mild acute biliary pacreatitis,MABP)、中重度ABP(moderately severe acute biliary pacreatitis,MSABP)和重度ABP(severe acute biliary pacreatitis,SABP)。比较各组间的入院48 h内血清PCT及CRP水平以及各组患者住院时的死亡率差异。结果:入院48 h内,ABP患者血清PCT水平高于急性非胆源性胰腺炎组[(11.1±5.11)μg/L比(3.86±1.64)μg/L](P<0.05),而2组间的CRP水平差异无统计学意义(P=0.342);SABP患者的血清PCT水平明显高于MABP及MSABP患者。入院48 h内,未来发生院内死亡的ABP患者血清PCT水平明显升高,高于存活患者(P<0.001),而这2组间的血清CRP水平差异无统计学意义(P=0.769)。结论:入院48 h内测得的血清PCT水平,对于AP患者病因的判断以及ABP严重度及预后的评估价值优于血清CRP。

Objective:To compare the value of procalcitonin(PCT)and c-reactive protein(CRP)in early diagnosis and treatment of acute biliary pancreatitis.Methods:Data from a total of 195 patients diagnosed with acute pancreatitis(AP)from January 2014 to March 2018 in Ruijin Hospital,Shanghai Jiao Tong University School of Medicine were retro-spectively analyzed.According to the etiology,the patients were divided into acute biliary pancreatitis(ABP)and acute non-biliary pancreatitis(ANBP)groups.And the ABP group was further divided into mild ABP(MABP),moderately severe ABP(MSABP)and severe ABP(SABP)groups according to the severity of the disease.Differences of PCT and CRP levels within 48 hours after admission and the in-hospital death rate were compared between these groups.Results:In the early48 hours after admission the level of PCT in patients with ABP was higher than that of ANBP(P<0.05),while there was no difference in CPR between 2 groups.Serum procalcitonin level within 48 hours after admission in SABP group was signifi-cantly higher than those in MABP and MSABP groups.Procalcitonin level within 48 hours after admission was significantly higher in the dead group than in the surviving group(P<0.001),and CRP levels within 48 hours after admission had little differences among these groups(P=0.769).Conclusions:In the early 48 hours after admission,the detection of serum PCT level is superior to CRP level for evaluating the severity and prognosis of ABP.