急性重症胰腺炎患者血清胆碱酯酶水平与预后的关系

The Relation between Serum Cholinesterase Level of Patients with Severe Acute Pancreatitis and Its Prognosis

目的:观察并探讨急性重症胰腺炎患者血清胆碱酯酶水平与预后的关系,为临床诊断病情和评估预后提供依据。方法:选取2011年1月-2014年1月在笔者所在医院接受急性重症胰腺炎治疗的50例患者作为研究组,同时选取50例健康志愿者作为对照组。研究组入院后抢救同时使用自动化分析仪器检测患者血清胆碱酯酶水平,对照组同样需要检测血清胆碱酯酶水平。统计信息并分析血清胆碱酯酶水平与患者APACHE-Ⅱ评分的关系,从而比较胆碱酯酶水平与预后的关系。结果:研究组血清胆碱酯酶在三个时间点的浓度水平均明显低于对照组,其中死亡组的血清胆碱酯酶水平明显低于存活组,存活组血清胆碱酯酶水平明显低于对照组,差异均有统计学意义(P<0.05)。患者血清胆碱酯酶水平与APACHE-Ⅱ评分呈反比,血清胆碱酯酶水平预测的准确性和阳性预测率均高于APACHE-Ⅱ评分,组间差异均有统计学意义(P<0.05)。结论:急性重症胰腺炎患者血清胆碱酯酶水平与其预后有着密切关联,具有较高的准确性和阳性预测率,可以作为临床上估计急性重症胰腺炎的病情、判断预后的有效指标,值得在临床上推广和使用。

Objective：To observe and investigate the relation between serum cholinesterase level of patients with severe acute pancreatitis（SAP） and its prognosis,so as to provide basis for the clinical diagnosis and prognosis evaluation.Method：50 SAP patients treated in our hospital from January 2011 to January 2014 were selected as the research group,and selected another 50 healthy volunteers as the control group.The research group admitted to hospital after the rescue while using automated analytical instrument to detect serum cholinesterase levels,the control group also needed to detect serum cholinesterase levels.The information was counted and the relationship between serum cholinesterase levels and patients with APACHE-Ⅱscore was analyzed,which compared the relationship between cholinesterase levels and prognosis.Result：The serum cholinesterase level of research group at three time point were significantly lower than the control group,and the level of dead group were significantly lower than survival group,level of survival group were lower than the control group,the differences were statistically significant（P〈0.05）.The accuracy and positive predictive values of serum cholinesterase level were significantly higher than APACHE-Ⅱscore, the differences were statistically significant between groups（P〈0.05）.Conclusion：There is a close relation between SAP and serum cholinesterase,with higher accuracy and positive predictive values,it can be used as the effective indicators for judgement and prognosis of SAP and widely promoted in clinic.