早期急性胰腺炎运用血清降钙素原的疗效分析

Therapeutic effect of serum procalcitonin in early acute pancreatitis

目的对血清降钙素原和急性胰腺炎严重程度的关系以及其早期预测作用进行探讨。方法选择本院收治的急性胰腺炎患者80例,按照病情分为重症组和轻症组,同时选择健康体检者40例成立常规组。于入院第1、3、5、7天测定患者血清降钙素原浓度、24 h内APACHEⅡ评分。结果第1天、第3天、第5天、第7天重症组PCT水平均显著高于轻症组、常规组,差异有统计学意义(P<0.05)。轻症组、常规组PCT水平对比差异无统计学意义。重症组APACHE评分显著高于轻症组,组间差异有统计学意义(P<0.05)。两组住院时间对比差异无统计学意义。经过Logistic回归分析PCT浓度、APACHEⅡ评分、住院时间均为重症急性胰腺炎危险因素。对于是否重症急性胰腺炎预测:重症为86.7%,非重症为97.2%,综合为94.2%。相关性分析中APACHEⅡ评分和PCT与是否重症存在明显相关性。结论重症急性胰腺炎患者会出现降钙素原浓度持续高于正常或明显上升,在预测重症急性胰腺炎中降钙素原具有一定作用,患者24 h内降钙素原浓度持续上升则提示为重症急性胰腺炎。

Objective To investigate the relationship between serum procalcitonin and the severity of acute pancreatitis and its early prediction.Methods Eighty patients with acute pancreatitis admitted to our hospital were enrolled.According to the condition,they were divided into severe group and mild group.At the same time,40 healthy people were selected to establish a routine group.Serum procalcitonin concentration and APACHEⅡscore within 24 hours were measured on days 1,3,5,and 7 after admission.Results The PCT levels in the severe group on Day 1,Day 3,Day 5,and Day 7 were significantly higher than those in the mild and routine groups(P<0.05).There was no significant difference in the PCT level between the mild group and the conventional group.The APACHE score of the severe group was significantly higher than that of the mild group,and the difference between the groups was statistically significant(P<0.05).There was no significant difference in the length of hospital stay between the two groups.Logistic regression analysis of PCT concentration,APACHE score,hospital stay were risk factors for severe acute pancreatitis.For the diagnosis of severe acute pancreatitis:severe cases were 86.7%,non-severe cases were 97.2%,and the total was 94.2%.There was a significant correlation between APACHE score and PCT in the relevant neutral analysis.Conclusion The procalcitonin concentration in patients with severe acute pancreatitis will continue to be higher than normal or significantly increased.Procalcitonin has a certain role in predicting severe acute pancreatitis.The procalcitonin concentration continues to rise within 24 hours for severe acute pancreatitis.