降钙素原及C反应蛋白联合检测在急性重度胰腺炎发生风险中的预测价值

Predictive value of procalcitonin and C-reactive protein in the severe acute pancreatitis

目的探讨早期降钙素原(PCT)及C反应蛋白(CRP)水平在急性重度胰腺炎发生风险中的预测价值。方法收集2013年1月至2015年12月在我院治疗的68例急性胰腺炎患者为研究对象进行回顾性研究。所有病例依照2013版中国急性胰腺炎诊疗指南将患者划分为轻度胰腺炎组(对照组),以及重度胰腺炎组(观察组)。通过t检验、Logistic回归以及ROC曲线分析起病24小时内的PCT及CRP水平与重度胰腺炎发生的相关性。结果观察组中PCT、CRP平均水平高于对照组(P<0.001),Logistic回归分析得到PCT、CRP的OR值分别为1.41、1.125,两者95%置信区间均>1,PCT、CRP均为重度胰腺炎的危险因素,可联合对重度胰腺炎发生风险进行预测。而ROC曲线提示PCT对重度胰腺炎预测敏感性及准确性要优于CRP。结论通过早期检测血清PCT和CRP水平能够对急性胰腺炎患者的病情严重程度提供帮助,而对重度胰腺炎早期综合治疗具有一定的临床指导价值。

Objective To explore the predictive value of procalcitonin （PCT） and C- reactive protein （CRP） in the severe acute pancreatitis （SAP）. Method A retrospective study in 68 cases of acute pancreatitis patients who accepted treatment in our hospital from Jan. 2013 to Dec. 2015 were conducted. All cases were divided into mild pancreatitis group （control group） and severe acute pancreatitis group （observation group） according to the 2013 edition of Chinese Acute Pancreatitis Diagnosis and Treatment Guideline. T-test, Logistic regression and ROC curve were utilized to analysis the correlation between PCT, CRP and the risk of severe acute pancreatitis within 24 hours of onset. Results The mean value of PCT and CRP in the observation group was significantly higher than control group （P〈 0.001）. By logistic regression analysis, the OR values of PCT and CRP were 1.41, 1.125 respectively. In both PCT and CRP, the confidence interval of the OR value of RP 95% was greater than one. Thus, both PCT and CRP were the risk factors for SAP and they could be combined to predict the risk of SAP. Furthermore, the ROC curves indicated that PCT was superior to CRP in sensitivity and accuracy for predicting the risk of SAP. Conclusion Early detection of serum PCT and CRP level could reflect the severity of AP patients, and PCT was more accurate and sensitive than CRP. Moreover, combination of PCT and CRP could predict the risk of SAP and provided valuable guidance for the SAP treatment.