多层CT联合血清淀粉酶、脂肪酶浓度检测在急性胰腺炎诊断中的应用

The application of multilayer CT combined with detection of serum amylase,lipase concentration in diagnosis of acute pancreatitis

目的观察分析多层CT联合血清淀粉酶、脂肪酶浓度检查在急性胰腺炎诊断中的应用。方法选取2010年3月至2015年8月收治的急性胰腺炎患者共计237例,根据患者病情分为轻型胰腺炎组(n=160)和重性胰腺炎组(n=77),另选取体检正常组患者98例作为对照组。比较患者的胰腺CT表现、应用不同检测方法对胰腺的检出率情况、血清中淀粉酶和脂肪酶含量以及体征和临床症状的缓解情况。结果应用多层CT检查对胰腺的检出率(96.31%)明显高于应用超声影像检查对胰腺的检出率(83.87%),差异有统计学意义(P<0.05)。重型胰腺炎组和轻型胰腺炎组患者的血清淀粉酶和脂肪酶含量均显著高于对照组患者,且重型胰腺炎组患者的水平又明显高于轻型胰腺炎组患者,差异有统计学意义(P<0.05)。两项指标联合检测的特异性、灵敏性和准确度明显高于单独一项指标检测,差异有统计学意义(P<0.05)。重型胰腺炎组患者的症状体征恢复时间均长于轻型胰腺炎组患者,差异有统计学意义(P<0.05)。结论多层CT、血清淀粉酶以及脂肪酶联合检测不仅能够提高诊断的准确度和阳性率,而且检查时间较短,有利于临床诊断。

Objective To investigate the significance of multilayer CT combined with the detection of serum levels of amylase and lipase in diagnosis of acute pancreatitis.Methods Two hundred and thirty-seven patients with acute pancreatitis who were admitted and treated in our hospital from March 2010 to August 2015 were enrolled in the study.According to the severity of pancreatitis,these patients were divided into mild pancreatitis group（ n = 160） and severe pancreatitis group（ n =77）,besides,98 healthy subjects were served as control group.The CT findings of pancreas,detection rate of different detection methods for pancreas,the serum levels of amylase and alleviation state of clinical signs and symptoms were observed and compared.Results The detection rate of pancreas by multi-CT examination was 96.31%,which was significantly higher than that（ 83.87%） by ultrasound imaging（ P〈0.05）.The serum levels of amylase and lipase in severe pancreatitis group and mild pancreatitis group were significantly higher than those in control group,furthermore,which in severe pancreatitis group were significantly higher than those in mild pancreatitis group（ P〈0.05）.The specificity,sensitivity and accuracy of combined detection with two indexes were significantly higher than those by one index（ P〈0.05）.The recovery time of clinical signs and symptoms in severe pancreatitis group was significantly longer than that in mild pancreatitis group（ P〈0.05）.Conclusion The combined detection of multilayer CT with serum amylase and lipase can improve the accuracy and positive rate in diagnosis of acute pancreatitis,moreover,the detection time is shorter,which is helpful for clinical diagnosis.