降钙素原及炎症指标对急性胰腺炎的早期诊断价值

Early diagnostic value of procalcitonin and inflammatory biomarkers for acute pancreatitis

目的研究降钙素原(PCT)及炎症指标对急性胰腺炎患者的早期诊断价值。方法选取2015年8月至2016年7月于我院诊治的急性胰腺炎患者80例作为观察组,另选取80例正常体检者作为对照组。分别比较两组受检者的血清PCT、C反应蛋白(CRP)以及白细胞介素-6(IL-6)水平。同时,根据病情严重程度将观察组患者分为重症急性胰腺炎(SAP)组34例,轻中型急性胰腺炎(MAP)组46例。分别比较两组患者治疗前后的血清PCT、CRP、IL-6水平以及急性生理与慢性健康(APACHEⅡ)评分。结果观察组患者的血清PCT、CRP和IL-6水平分别为(3.4±0.5)ng/mL、(124.3±22.1)mg/L和(48.6±14.3)ng/L,均显著高于对照组的(0.6±0.3)ng/mL、(5.7±1.5)mg/L及(6.5±0.8)ng/L,差异均有显著统计学意义(P<0.01);SAP组和MAP组患者治疗后的血清PCT水平均显著高于治疗前,且治疗前和治疗后SAP组患者的PCT水平分别为(4.8±1.4)ng/mL、(10.2±3.3)ng/mL,显著高于MAP组的(1.7±0.6)ng/mL、(4.2±0.9)ng/mL,差异均有显著统计学意义(P<0.01);SAP组和MAP组患者治疗后的血清CRP、IL-6水平均显著高于治疗前,且治疗前和治疗后SAP组患者的CRP水平分别为(28.5±3.7)mg/L、(114.9±21.5)mg/L、IL-6水平分别为(85.6±27.8)ng/L、(295.5±37.3)ng/L,均显著高于MAP组的(20.2±3.2)mg/L、(67.7±11.1)mg/L、(27.6±7.6)ng/L、(173.2±13.6)ng/L,差异均有显著统计学意义(P<0.01)。治疗前和治疗后SAP组APACHEⅡ评分为(8.4±4.1)分、(7.8±3.7)分,明显低于MAP组的(11.7±5.4)分、(11.3±3.7)分,差异均有统计学意义(P<0.01)。结论联合检测患者血清PCT、CRP及IL-6水平可有效诊断患者病情严重程度,有助于指导临床诊疗。

Objective To study early diagnostic value of procalcitonin （PCT） and inflammatory biomarkers for acute pancreatitis. Methods From August 2015 to July 2016, 80 patients with acute pancreatitis in our hospital were en-rolled as observation group, and another 80 healthy individuals for physical examination were selected as control group. Serum PCT and C-reactive protein （CRP） and interleukin-6 （IL-6） levels were compared between the two groups. At the same time, according to the severe degree, the patients were divided into severe acute pancreatitis group （SAP group, 34 cas-es） and mild-to-moderate acute pancreatitis group （MAP group, 46 cases）, which were compared in serum PCT, CRP, IL-6 levels and APACHEⅡscore before and after treatment. Results The serum PCT, CRP, IL-6 levels were （3.4±0.5） ng/mL, （124.3±22.1） mg/L, （48.6±14.3） ng/L in the observation group, which were significantly higher than （0.6±0.3） ng/mL, （5.7± 1.5） mg/L, （6.5 ± 0.8） ng/L in the control group （P〈0.05）. PCT levels in SAP group were （4.8 ± 1.4） ng/mL before treatment and （10.2 ± 3.3） ng/mL after treatment, which were significantly higher than （1.7 ± 0.6） ng/mL, （4.2 ± 0.9） ng/mL in MAP group （P〈0.05）, and the serum PCT levels after treatment in SAP group and MAP group were significantly higher than those before treatment. The CRP, IL-6 levels in SAP group before and after treatment were （28.5±3.7） mg/L and （114.9± 21.5） mg/L, （85.6 ± 27.8） ng/L and （295.5 ± 37.3） ng/L, which were all significantly higher than （20.2 ± 3.2） mg/L and （67.7 ± 11.1） mg/L, （27.6 ± 7.6） ng/L and （173.2 ± 13.6） ng/L in MAP group （P〈0.05）. The levels after treatment in SAP group and MAP group were significantly higher than those before treatment. APACHEⅡscore in SAP group before and after treatment were （8.4 ± 4.1） and （7.8 ± 3.7）, which were significantly lower than （11.7 ± 5.4） and （11.3 ± 3.7） in MAP group （P〈0.05）. Conclusion Combined detection of serum PCT, CRP and IL-6 level can be effective in the diagnosis of patients with severe degree, which helps to guide the clinical diagnosis and treatment.