3项指标联合检测对急性胰腺炎的诊断和预后价值

Value of joint detection of three indicators in diagnosis and prognosis of patients with acute pancreatitis

目的探究血液淀粉酶(AMY)、脂肪酶(LPS)、C反应蛋白(CRP)联合检测对急性胰腺炎(AP)的临床诊断及预后评估价值,为AP临床治疗提供实践性导向。方法选取苏州市立医院2013年3月至2014年2月收治的50例AP患者,其中轻度胰腺炎(MAP)组22例,重度胰腺炎(SAP)组28例;并选择同期非胰腺炎急腹症(NAA)患者50例为NAA组;选取同期健康体检的50例健康人,设为健康对照组。比较MAP组、SAP组、健康对照组、NAA组于入院当天以及入院后第3、5、7天的AMY、LPS、CRP指标。结果 (1)入院当天:SAP组与MAP组的AMY、LPS和CRP值均高于NAA组和健康对照组,差异有统计学意义(P<0.05);NAA组AMY、CRP值高于健康对照组,差异有统计学意义(P<0.05);NAA组LPS水平和健康对照组差异无统计学意义(P>0.05);SAP组CRP水平明显高于MAP组,差异有统计学意义(P<0.05),但SAP组的AMY、LPS值与MAP组相比,差异无统计学意义(P>0.05)。(2)入院后:SAP组及SAP组于入院后第3、5、7天的CRP值均高于健康对照组,差异有统计学意义(P<0.05);SAP与MAP组入院后第7天的CRP值均低于入院时,差异有统计学意义(P<0.05)。(3)联合AMY、LPS、CRP指标检测的诊断正确率均高于单独应用各项指标,差异有统计学意义(P<0.05)。结论AMY、LPS、CRP联合检测能提高AP的正确诊断率,并可作为病情严重程度及预后康复的评价指标。

Objective To explore value of blood amylase（AMY）,lipase（LPS）and C reactive protein（CRP）of acute pancreatitis（AP）patients in diagnosis and assessment of prognosis,and to provide practical guidance for clinical treatment of the disease.Methods A total of 50 patients with AP from March 2013 to February 2014 were selected in this study,including 22 cases in（mild pancreatitis）MAP group,28 cases in（severe acute pancreatitis）SAP group.Other 50 patients with acute abdominal disease who weren′t got pancreatitis were selected into normal acute abdominal（NAA）group.A total of 50 healthy people were selected in control group.The levels of AMY,LPS and CRP were compared among the three groups at different time.Results At the admission day：（1）The levels of AMY,LPS and CRP in the SAP group and MAP group were higher than those in the NAA group and the control group（P〈0.05）;AMY,CRP levels in NAA group were higher than those in the control group（P〈0.05）;the level of LPS in the NAA group had no significant difference with those of the control group（P〉0.05）;the level of CRP in SAP group was significant higher than that in group MAP（P〈0.01）,but the AMY,LPS levels in the SAP group had no significant difference with those of the MAP group（P〉0.05）.（2）After admission：CRP levels in SAP group3,5,7days after admission were higher than those in the control group,the difference was statistical significant（P〈0.05）,but the levels of CRP at 7days after admission in the SAP and MAP group were lower than those after admission,the differences was statistically significant（P〈0.05）.（3）Diagnostic accuracy rate of combined detection of AMY,LPS,CRP were higher than those of the single indicator,the differences were statistically significant（P〈0.05）.Conclusion The joint detection of AMY,LPS,CRP could improve the correct diagnostic rate of AP,and could be used as evaluation index of the severity and prognosis of rehabilitation.