血清sFlt-1、LDH及hs-CRP联合检测对重型急性胰腺炎的早期诊断价值

A Study of the Diagnosis Value for Combined Detection of Serum sFlt-1,LDH and hs-CRP in the Early Diagnosis of Severe AP

目的分析研究血清中可溶性Fms样酪氨酸激酶-1 (sFlt-1)、乳酸脱氢酶(LHD)和超敏反应蛋白(hs-CRP)联合检测对重型急性胰腺炎(AP)的早期诊断价值。方法选择我院于2015年1月至2017年12月收治的因急性腹痛来院治疗的AP患者93例,并根据诊断结果分为轻度组(MAP)和重度组(SAP)。同时按照病例对照设计原则选取等额的受试者作为健康对照组。收集所有研究对象的基本资料,如年龄、性别等,并采用常规检测其血清LHD和hs-CRP水平,酶联免疫吸附法(ELISA)检测血清sFlt-1水平,通过SPSS20.0统计软件对研究对象的基本资料以及各检测指标进行描述和统计分析,并计算各指标的诊断灵敏度及其对重型AP患者的诊断价值。结果三组受试者在年龄、性别上差异无统计学意义,其基本资料具有可比性;此外,三组受试者的血清sFlt-1、LHD和hs-CRP水平差异均有统计学意义(均有P <0.001);除SAP组sFlt-1水平与健康对照组差异没有统计学意义外,MAP组和SAP组均与健康对照组水平差异存在统计学意义(均有P <0.05)。另外血清sFlt-1对SAP患者的单独检测的灵敏度为80.4%,特异性为76.5%,LHD的灵敏度为86.3%,特异性为89.4%,hs-CRP检测的灵敏度为68.8%,特异性为83.7%,且三者联合检测的灵敏度为91.6%,特异性为93.5%,即血清sFlt-1、LHD和hs-CRP联合检测对重型急性胰腺的早期诊断优于其中任何方法的单一检测。结论血清sFlt-1、LHD和hs-CRP联合检测对重型急性胰腺炎的早期诊断具有一定的诊断价值,且优于其中任何单一检测,对急性胰腺炎的发生和病情发展具有重要的临床意义。

Objective To analyze the diagnosis value of the combined detection of soluble Fms-like tyrosine kinase-1(sFlt-1),lactate dehydrogenase(LHD)and hypersensitive C-reactive protein(hs-CRP)in serum for severe acute pancreatitis(AP). Methods A total of 93 patients with AP who were admitted from January 2015 to December 2017 were selected for the study.They were divided into the mild and severe groups.At the same time,the same number of subjects were selected as the healthy control group according to the case-control design principle.We collected basic data of all subjects,such as age,gender,etc.The routine blood test was used to measure the serum LHD and hs-CRP levels,also enzyme-linked immunosorbent assay(ELISA)was applied to detect the serum sFlt-1 level,SPSS20.0 statistical software package was used for statistical analysis.The sensitivity of each index was calculated to test its diagnostic value for patients with severe AP. Results There were no significant differences in age and gender among the three groups.The basic data was comparable across groups.There were significant differences in serum sFlt-1,LHD and hs-CRP levels among the three groups, P <0.001;Except for the sFlt-1 level in the SAP group and the healthy control group,there were no significant differences between the MAP group,the SAP group and the healthy control group,respectively, P <0.05.In addition,the sensitivity of serum sFlt-1 to SAP patients was 80.4%,the specificity 76.5%;the sensitivity of LHD was 86.3%,the specificity 89.4%;the sensitivity of hs-CRP detection was 68.8%,and the specificity 83.7.%;and the combined detection of three makers had a sensitivity of 91.6%,the specificity 93.5%.,suggesting the better performance of the combined detection over the single detection in the early diagnosis of severe acute pancreas. Conclusion The combined detection of serum sFlt-1,LHD and hs-CRP has certain diagnostic value for the early diagnosis of severe acute pancreas,with a superior power relative to any single detection.It has an important clinical significance for the detection of occurrence and development of acute pancreatitis.