急性胰腺炎CT分级与C反应蛋白测定评估炎症严重程度的对比研究

The Comparative Study on CT Grade and CRP Test for Evaluating the Severity of Acute Pancreatitis

目的:探讨CT分级与C反应蛋白(CRP)测定对急性胰腺炎的严重程度及预后评估的价值及相关性。材料与方法:收集我院2013年6月-2014年12月临床诊断的60例急性胰腺炎患者作为研究对象,所有患者发病3天内即行CT扫描,并于发病第1、3、5、7、14天进行C反应蛋白测定,将所得资料与临床病变过程进行分析、对照。结果:60例急性胰腺炎中轻度(MAP)42例、中重度(MSAP)11例、重度(SAP)7例。MAP组CT分级主要集中在B、C、D级,占90.47%(38/42),MSAP及SAP组主要集中在D、E级,占83.33%(15/18)。MAP组CRP峰值为92.71±23.35 mg/L,MSAP组CRP峰值为142.59±35.61 mg/L,SAP组CRP峰值为158.33±47.13 mg/L,MAP组与MSAP组、SAP组比较,差异具有统计学意义(P<0.05),而MSAP组与SAP组比较,差异无统计学意义(P>0.05),CRP浓度变化与炎症转归呈正相关。结论:急性胰腺炎的CT分级与C反应蛋白测定可以反映炎症严重程度和预后,两者均可以作为评价急性胰腺炎的重要参考因素。

Purpose： To explore the value and correlation of CT grade and C-reaction protein （CRP） test for evalua- ting the severity and prognosis of acute pancreatitis. Materials and Methods： 60 cases of acute pancreatitis were involved in this research from June 2013 to December 2014. All patients received CT scan in the first three days, and were detected CRP level at the first, third, fifth, seventh and fourteenth day. The information were analyzed and compared with the clinical process. Results： The 60 patients were divided into three groups, which contained 42 patients with mild acute pancreatitis （MAP）, 11 patients with moderate to severe acute pancreatitis （MSAP）, and 7 patients with severe acute pancreatitis （SAP）. The CT grades of MAP group mainly focused on grade B, C and D （38/42, 90. 47% ）, MSAP and SAP groups fo- cused on Grade D and E （ 15/18, 83.33% ）. The peak CRP level for MAP group was 92.71±23. 35mg/L, for MSAP group was 142. 59 ±35.61 mg/L, and for SAP group was 158. 33 ±47. 13 mg/L. When compared MAP group with MSAP and SAP groups, the difference of CRP was statistical significant （ P 〈 0. 05 ）, but there was no significantly difference between MSAP and SAP groups （ P 〉 0. 05 ）, and the CRP level was positively correlated with the prognosis of disease. Conclusion： The CT grade and CRP level of acute pancreatitis can reflect prognosis and the severity of inflammation, and they can serve as impor- tant reference factors for evaluating acute pancreatitis.