SAA、PCT、hs-CRP和TPS-2联合检测在急性胰腺炎诊断中的价值

The value of combined detection of SAA,PCT,hs-CRP and TPS-2 levels in the new classification of acute pancreatitis

目的探讨血清淀粉样蛋白A(SAA)、降钙素原(PCT)、超敏-C反应蛋白(hs-CRP)和尿胰蛋白酶原-2(TPS-2)在急性胰腺炎中的诊断价值。方法选择2016年6月至2017年11月在该院急诊科就诊的急腹症患者,其中61例为急性胰腺炎患者(AP组),112例为非急性胰腺炎急腹症患者(非AP组),同时选取60例健康体检者为对照组。AP组又按2012年AP新分型标准,分为轻度急性胰腺炎(MAP)组、中度急性胰腺炎(MSAP)组、重度急性胰腺炎(SAP)组,其中MAP组36例、MSAP组19例、SAP组6例。采用免疫散射比浊法检测SAA、hs-CRP,酶法检测AMS与LPS,免疫荧光法测定PCT和免疫层析法检测TPS-2。结果 AP组的SAA、PCT、hs-CRP和TPS-2阳性率与非AP组和对照组比较,差异有统计学意义(P<0.05);非AP组与对照组比较,差异有统计学意义(P<0.05)。TPS-2在各型AP组间比较,差异无统计学意义(P>0.05)。SAP组SAA、PCT、hs-CRP水平显著高于MAP组和MSAP组,差异有统计学意义(P<0.05)。结论联合检测SAA、PCT、hs-CRP、TPS-2可为急腹症与急性胰腺炎的鉴别诊断及严重程度划分提供可靠依据,值得在临床中推广应用。

Objective To investigate the value serum amyloid A（SAA）,procalcitonin（PCT）,high sensitive-C reactive protein（hs-CRP）and urinary trypsinogen-2（TPS-2）in diagnosis of acute pancreatitis and its new typing.Methods Patients with acute abdomen from June 2016 to November 2017 in the emergency department of our hospital were selected.And there were 61 cases with acute pancreatitis（group AP）and 112 cases with acute abdomen of non-acute pancreatitis（non AP group）,and 60 healthy subjects（control group）were selected.According to the 2012 AP new classification standard,group AP was divided into mild AP（MAP）group,moderate AP（MSAP）group and severe AP（SAP）group,and there were 36 cases,19 cases and 6 cases in each groups.SAA and hs-CRP were detected by immuno scattering turbidimetry,AMS and LPS were detected by enzyme method,PCT and TPS-2 were detected by immunofluorescence and immunochromatography.Results SAA,PCT,hs-CRP and TPS-2 of AP group were significantly higher than that of non AP group and the control group（P〈0.05）.The indicators of non-AP group were significantly higher than that of the control group（P〈0.05）.There was no significant difference in TPS-2 between three groups（P〈0.05）.SAA,PCT and hs-CRP in SAP group were significantly higher than those of MAP group and MSAP group（P〈0.05）.Conclusion Combined detection of SAA,PCT,hs-CRP and TPS-2 have clinical significance in the diagnosis of acute pancreas and the new typing.It could provide important data for the division of severity of AP,which is worthy of promotion.