羧肽酶B活性肽和磷脂酶A2在急性胰腺炎临床诊断中的价值

The clinical diagnostic value of CAPAP and PLA2 in acute pancreatitis

目的评估羧肽酶B活性肽(CAPAP)和磷脂酶A2(PLA2)在急性胰腺炎(acute pancreatitis,AP)临床诊断中的价值。方法选取2013年7月-2015年7月因急性腹痛于湖北医药学院附属人民医院就诊的疑似AP患者148例,其中轻度急性胰腺炎(MAP)组患者52例,重度急性胰腺炎(SAP)组患者40例,非急性胰腺炎急腹症组(non-acute pancreatitis abdomen,NAP)56例,同时选取同期进行常规体检的健康人群42名作为对照组,分别采用胶体金法和ELISA法检测四组患者的尿CAPAP及血清PLA2水平,并比较血清淀粉酶(Amy)、PLA2及尿CAPAP在SAP早期诊断中的效能。结果与对照组和NAP组相比,MAP组和SAP组患者的尿CAPAP阳性率和血清PLA2水平均显著升高,且随患者病情严重程度的加重而升高(P<0.05);血清PLA2及尿CAPAP在SAP的诊断灵敏度、特异度、准确度、阳性预测值及阴性预测值等较血清Amy显著升高,且尿CAPAP的诊断效能明显优于血清Amy和PLA2(P<0.05)。结论血清PLA2及尿CAPAP均可用于AP的辅助诊断,多项指标联合检测可显著提高AP的诊断灵敏度和特异度,具有较高的参考价值。

Objective To evaluate the clinical diagnostic value of carboxypeptidase B activation peptide（CAPAP）and phospholipase A2（PLA2）in acute pancreatitis（AP）.Methods One hundred and forty-eight patients with suspected AP from Jul.2013 to Jul.2015 in the People＆#39;＆#39;s Hospital Affiliated to Hubei Medical College were selected as the MAP group,SAP group and NAP group,and 42 cases of healthy people were selected as the control group.The urine CAPAP and serum PLA2 levels were detected by colloidal gold and ELISA method,respectively.And the diagnostic efficacy of serum Amy,PLA2 and urine CAPAP in SAP were compared.Results Compared with control group and NAP group,the urine CAPAP positive rate and serum PLA2 level in MAP group and SAP group were not only significantly increased,but also increased with the aggravation of the AP patients（P〈0.05）.Besides,the diagnostic efficacy of serum Amy,PLA2 and urine CAPAP in SAP showed that the sensitivity,specificity,accuracy,positive predictive value and negative predictive value of serum PLA2 and urine CAPAP in SAP were significantly increased,and especially the urine CAPAP（P〈0.05）.Conclusion The serum PLA2 and urine CAPAP can be applied to AP diagnosis,the diagnostic sensitivity and specificity of AP can be highly increased by multiple indicators detection,and it has an important reference value to the treatment of AP.