早期C反应蛋白水平测定对预测轻重症急性胰腺炎的临床意义

The clinical value of earner period C reactive protein level in predicting the mild and severe acute pancreatitis

目的 探讨急性胰腺炎（AP）早期血清C反应蛋白（CRP）水平对预测AP分型和预后的临床意义。方法 AP患者43例，入院后立即采用免疫散射速率比浊法测定血清CRP水平，7d后评估AP的轻重分型。根据血清CRP水平分为两组：CRP≤300mg／L（I组）和CRP〉300mg／L（Ⅱ组）。对两组患者血清CRP水平与胰腺增强ＣT检查分级及各种影响AP预后的临床指标（血钙、血脂、血糖、血气分析）进行比较分析。结果 Ⅱ组患者中肥胖（62．5％）、原发性高血压（31．2％）、脂肪肝（62．5％）、高脂血症（56．2％）、高血糖（62．5％）、低钙血症（56．2％）比例明显高于Ⅰ组，两组比较差异有统计学意义（P〈0．05）。Ⅱ组患者胰腺增强ＣT检查分级多为Ｃ级及Ｃ级以上，重症AP发生率明显高于Ⅰ组，两组比较差异有统计学意义（P〈0．05）。结论 以血清CRP300mg／L作为诊断阈值界定。在AP早期测定来预测患者病情轻重及判断预后，对指导临床治疗有重要参考价值。

Objective To analyze the clinical value of serum C reactive protein （CRP） level in earlier period in predicting the typing and prognosis of acute panereatitis （AP）. Methods Serum CRP levels of 43 patients with AP were measured at the time of admission by immunoturbidimetry method, and evaluated AP type afeter 7 days. Patients were classified into two groups depending on the levels of CRP：group Ⅰ with the level of CRP≤300 nag/L, and group Ⅱ with the level of CRP 〉 300 mg/L. The serum CRP,panereatie enhancement CT grade and prognostic indexes （blood calcium, blood lipid, blood sugar, blood gas analysis） were analyzed. Results Cases with obesity（62.5%）,hypertension（31.2%）,hepar acliposum（62.5%）,hyperlipemia（56.2% ） ,hyperglycemia（62.5% ）, hypoealcemia（56.2% ） in group Ⅱ were higher than those in group Ⅰ （P〈0.05）. The pancreatic enhancement CT grade of most patients in group Ⅱ was over C grade, and the incidence of severe AP in group Ⅱ was higher than that in group Ⅰ （P〈 0.05）. Conclusions The level of CRP 300 mg/L which acts as the diagnostic liminal value,can be an clinical index for predicting the severity of AP and the patient＇s progress in earlier period to the patients with AP. And it has important reference value to the guidance of clinical treatment.