6项检测指标在急性胰腺炎诊断中的价值探讨

The value discuss of 6 indexes in the diagnosis of acute pancreatitis

目的探讨血淀粉酶(S-Amy)、胰脂肪酶(LPS)、蛋白酶原激活肽(TAP)、C-反应蛋白(CRP)、白细胞介素-6(IL-6)和尿胰蛋白酶原-2(Tgb-2)对急性胰腺炎(AP)早期诊断和病情评估的价值。方法检测100例急性胰腺炎患者(包括60例轻型胰腺炎,40例重型胰腺炎),100例非胰腺炎急腹症患者,50例健康者的S-Amy、LPS、TAP、CRP、IL-6和Tgb-2,并对检测结果进行比较分析。结果 AP患者S-Amy、Tgb-2,TAP水平均高于非AP组,非AP组高于健康组,各组间差异均有统计学意义(P<0.01);AP组LPS水平明显高于非AP组和健康对照组,差异有统计学意义(P<0.01),而非AP组和健康对照组间的差异无统计学意义(P>0.05);AP组和非AP组之间CRP、IL-6水平差异无统计学意义(P>0.05),但均高于健康对照组(P<0.01)。SAP组TAP、CRP及IL-6水平明显高于MAP组,差异有统计学意义(P<0.01),而S-Amy、LPS、Tgb-2水平2组间无差异(P>0.05)。在AP的诊断中,Tgb-2特异性和敏感性最高,其次是LPS。结论在AP的诊断中,Tgb-2敏感性和特异性高于S-Amy和LPS,Tgb-2是鉴别AP的最好标志物,联合S-Amy和LPS检测有助于提高诊断的准确性,而TAP、CRP、IL-6则有助于病情评估和疗效观察。

Objective Exploration the value of amylase（S-Amy）,lipase（LPS）,trypsinogen activation peptide（TAP）,C reactive protein（CRP）,interleukin 6（IL-6） and urinary trypsinogen-2（Tgb-2） in early diagnosis and severity assessment to the acute pancreatitis（AP）.Methods S-Amy,LPS,TAP,CRP,IL-6 and Tgb-2 were analyzed in 100 cases of AP patients（including 60 patients with mild AP,40 cases of severe pancreatitis）,100 cases of non-pancreatitis patients with acute abdomen,50 cases of healthy people.Results S-Amy,Tgb-2,TAP levels in AP group were higher than non-AP group,non-AP group higher than those in normal group,there were statistically significant difference between each groups（P 0.01）.Group AP LPS level was significantly higher than the AP group and normal control group（P0.01）,but non AP group and normal control group differences was no statistically significant（P0.05）.CRP,IL-6 level there was no statistically significant difference between AP group and AP group,but was higher than those in normal control group（P0.01）.In SAP group TAP,CRP and IL-6 levels was significantly higher than those in MAP group（P0.01）,but S-Amy,LPS,Tgb-2 levels between the 2 groups had no difference（P 0.05）.In the diagnosis of AP,Tgb-2 specificity and sensitivity was the highest.Conclusion In the diagnosis of AP,sensitivity and specificity of Tgb-2 could be higher than S-Amy and LPS.Tgb-2 may be the best marker for identification of acute pancreatitis,combined detection with S-Amy and LPS could help to improve diagnostic accuracy,while TAP,CRP,IL-6 may contribute to the assessment of disease severity and clinical observation.