重症急性胰腺炎患者C反应蛋白及血清降钙素原的变化

Changes of C reactive protein and serum procalcitonin in patients with severe acute pancreatitis

目的探讨重症急性胰腺炎(SAP)患者C反应蛋白(CRP)及血清降钙素原(PCT)的变化。方法选取90例SAP患者为SAP组,另选取90例轻症急性胰腺炎患者为MAP组,100例来院参加体检的健康体检者为对照组。检测3组患者的CRP及PCT水平,并分析二者联合诊断价值。结果SAP组患者血清CRP、PCT水平高于MAP组,MAP组高于对照组,差异均有统计学意义(P<0.05)。血清PCT诊断的ROC曲线下降面积为0.87,最佳节点为≥3ng/mL;血清CRP诊断的ROC曲线下降面积为0.79,最佳节点为≥50mg/L。二者联合诊断的阴性似然比为0.14,阳性似然比为4.14,准确度为88.20%,特异度为86.40%,敏感度为91.50%。结论SAP患者CRP及血清PCT水平与病情发展呈正相关,且二项指标联合诊断的准确度、特异度、敏感度均较高。

Objective To investigate the changes of C reactive protein (CRP) and procalcitonin (PCT) in patients with severe acute pancreatitis (SAP). Methods Ninety patients with SAP were selected as SAP group, and 90 patients with mild acute pancreatitis were selected as MAP group, and 100 healthy people with physical examination were selected as control group. The CRP and PCT levels were detected in the three groups, and the combined diagnostic value of the two indexes was analyzed. Results The serum levels of CRP and PCT were the highest in SAP group and the lowest in control group, and there were significant differences among three groups ( P <0.05). The declining area of ROC curve for serum PCT diagnosis was 0.87, and the optimum node was greater than or equal to 3 ng/mL. The declining area of ROC curve for serum CRP diagnosis was 0.79, and the optimum node was greater than or equal to 50 mg/L. For combination of two indexes, the negative likelihood ratio was 0.14, the positive likelihood ratio was 4.14, the accuracy was 88.20%, the specificity was 86.40%, and the sensitivity was 91.50%. Conclusion CRP and serum PCT levels are positively correlated with the development of SAP, and the accuracy, specificity and sensitivity of the combined diagnosis of the two indicators are higher.