尿胰蛋白酶原-2快速检测在急性胰腺炎早期诊断中的应用

Appling rapid urine trypsinogen-2 test to early diagnosis of acute pancreatitis

目的:评价尿胰蛋白酶原-2快速检测在急性胰腺炎早期诊断中的价值。方法:检测85例因急性腹痛而就诊的急诊或住院的病人血、尿淀粉酶,血脂肪酶及尿胰蛋白酶原-2,按照《胰腺炎诊断标准》判断是否患有胰腺炎,分为急性胰腺炎组和非急性胰腺炎组,计算尿胰蛋白酶原-2阳性诊断急性胰腺炎的性能指标,以临床诊断急性胰腺炎统计尿胰蛋白酶原-2、血淀粉酶、尿淀粉酶的ROC曲线及尿胰蛋白酶原-2阳性在尿液中持续时间。结果:尿胰蛋白酶原-2诊断急性胰腺炎的特异度89.2%,敏感度97.9%,阴性预示值97.1%,阳性预测值92.2%,准确性94.1%。与血清淀粉酶比较P>0.05,与尿淀粉酶比较P<0.05,尿TPS-2、血淀粉酶、尿淀粉酶的ROC曲线下的面积分别为0.860、0.823、0.821。结论:尿胰蛋白酶原-2快速检测简便、快速、微量、特异,为AP的早期实验室诊断提供更加特异、准确的诊断依据。

Objective：To assess the value of rapid measurement of urina-ry trypsinogen-2（TPS-2）for early diagnosis of acute pancreatitis（AP）. Methods：Blood and urine amylase,lipase and TPS-2 were determined in 88 emergency cases or inpatients with acute abdominal pain for initial di-agnosis on the Guidelines for Diagnosis and Treatment of Acute Pancreati-tis in China basis.The total patients were then allocated to group of AP and non-AP,and the diagnostic accuracy of the markers of TPS-2 were e-valuated by receiver-operating characteristic（ ROC） curve analysis pertain-ing to the urine TPS-2,serum amylase and urine amylase as well as re-solved time of TPS-2 in the urine.Results：The specificity and sensitivity for AP by determination of TPS-2 were 89.2% and 97.1%,and the nega-tive predictive value,positive predictive value and accuracy of urine TPS-2 were 97.1%,92.2% and 94.1%,respectively.The difference was not significant with the reference values of serum amylase（P〉0.05）,yet was significant compared with urine amylase（P〈0.05）.The area under the curve of the ROC plot described urine TPS-2,serum amylase and urine amylase by 0.860,0.823 and 0.821, respectively.Conclusion：Urine TPS-2 dipstick test may be simple and quick for early diagnosis of AP for its higher specificity,sensitivity and accuracy.