CT联合血清AMY、LPS水平检测对急性胰腺炎的诊断价值

Clinical value of CT combined with serum AMY and LPS detection in the diagnosis of acute pancreatitis

目的探讨CT联合血清脂肪酶（LPS）、淀粉酶（AMY）水平检测在急性胰腺炎（AP）诊断中的应用价值。方法选取AP患者62例设为研究组，均经病理检查确诊，依据病情程度分为急性轻症胰腺炎（MAP）43例和急性重症胰腺炎（SAP）19例；另选同期非胰腺炎急腹症患者61例设为对照组。比较研究组与对照组及研究组不同病情程度患者血清LPS、AMY表达水平，分析血清LPS、AMY表达水平与AP病情程度的相关性；以病理检查结果作为“金标准”，比较血清LPS、AMY水平单一检测方法、CT检测方法及联合检测方法的AP检测结果。结果研究组血清LPS、AMY表达水平高于对照组，差异有统计学意义（P〈0．05）；SAP患者血清LPS、AMY表达水平高于MAP患者，差异有统计学意义（P〈0．05）；经Spearman相关分析显示，血清LPS、AMY表达水平与AP病情程度之间呈正相关（P〈0．05）；血清LPS、AMY水平与CT联合检测AP的敏感性、特异性、准确性均高于单一检测，差异有统计学意义（P〈0．05）。结论血清LPS、AMY表达水平与AP发生、进展密切相关，血清LPS、AMY水平与CT联合检测方法诊断AP，可明显提高诊断敏感性、特异性、准确性，有助于疾病临床控制及病情评估。

Objective To assess the value of CT combined with serum lipase （LPS） and amylase （AMY） levels detection in the diagnosis of acute pancreatitis （AP）. Methods Sixty-two patients with AP confirmed by pathology were selected as study group, and then were further divided into acute mild pancreatitis （ MAP , 43 cases ） and acute severe pancreatitis （ SAP , 19 cases ） according to the degree of disease; and 61 non-pancreatitis patients were selected as control group. Serum LPS and AMY expression levels were compared between study group and control group and between the patients with MAP and SAP in study group; correlation of serum LPS and AMY expression with the degree of AP was analyzed; the results of pathological examination were considered as the ＂gold standard＂ to compare the detection results of AP by serum LPS, AMY level alone detection method, CT detection method and combined detection method. Results The levels of serum LPS and AMY in study group were significantly higher than those in control group （ P 〈 0.05） ; the levels of serum LPS and AMY in SAP patients were significantly higher than those in MAP patients （ P 〈 0.05 ） ; Spearman correlation analysis showed that there was a positive conelation of serum LPS and AMY expression level with AP severity （P 〈 0.05 ） ; the sensitivity, specificity and accuracy of serum LPS, AMY and CT combined detection method were significantly higher than those of signal detection methods, the difference was statistically significant （P 〈 0.05 ）. Conclusions Serum LPS and AMY expression levels are closely related to the occurrence and progression of AP; the serum LPS, AMY and CT combined detection method in the diagnosis of AP can significantly improve the diagnostic sensitivity, specificity and accuracy, and contribute to the clinical control and disease evaluation.