血清抗凝血酶Ⅲ联合改良CT严重指数评估急性胰腺炎严重程度及预后的价值

Value of serum antithrombin-Ⅲcombined with modified CT severity index in the evaluation of severity and prognosis of patients with acute pancreatitis

目的:探讨血清抗凝血酶-Ⅲ(AT-Ⅲ)联合改良CT严重指数(MCTSI)评估急性胰腺炎(AP)病人病情严重程度及预后的价值。方法:124例AP病人根据病情严重程度分为MAP组(38例)、MSAP组(46例)、SAP组(40例),根据预后不同分为存活组(110例)、死亡组(14例)。比较各组AP病人血清AT-Ⅲ水平及MCTSI评分,采用ROC曲线分析血清AT-Ⅲ联合MCTSI评分诊断SAP和预测AP病人死亡的价值。结果:不同病情严重程度AP病人血清AT-Ⅲ水平及MCTSI评分比较差异均有统计学意义(P<0.01),AP病人随着病情严重程度增加,血清AT-Ⅲ水平降低,而MCTSI评分增加(P<0.01);死亡组病人血清AT-Ⅲ水平低于存活组,而MCTSI评分高于存活组,差异均有统计学意义(P<0.01);血清AT-Ⅲ联合MCTSI评分评估AP严重程度和预测AP病人死亡的AUC、敏感度及特异度均优于单一检测。结论:血清AT-Ⅲ联合MCTSI在评估AP病人病情严重程度及预后方面具有较高的临床价值。

Objective:To study the value of the serum antithrombin-Ⅲ(AT-Ⅲ)combined with modified CT severity index(MCTSI)in the evaluation of severity and prognosis of patients with acute pancreatitis(AP).Methods:One hundred and twenty-four AP patients were divided into the MAP group(38 cases),MSAP group(46 cases)and SAP group(40 cases)according to the severity of the disease,and the survival group(110 cases)and death group(14 cases)according to the prognosis.The serum levels of AT-Ⅲand MCTSI scores among the groups were compared.The value of serum AT-Ⅲcombined with MCTSI in the diagnosis of SAP and predicting the death in patients with AP were analyzed using the ROC curve.Results:The differences of the serum levels of AT-Ⅲand MCTSI scores among different disease severity of AP patients were statistically significant(P<0.01).With the severity of disease increasing,the serum levels of AT-Ⅲdecreased,and the MCTSI scores increased(P<0.01).The serum level of AT-Ⅲin death group was significantly lower than that in survival group(P<0.01),while the MCTSI score was significantly higher than that in survival group(P<0.01).The AUC,sensitivity and specific degrees of serum AT-Ⅲcombined with MCTSI in the evaluation of AP severity and predicting of death in patients with AP were superior to single detection.Conclusions:The serum AT-Ⅲcombined with MCTSI in the assessment of disease severity and prognosis of patients with AP has a higher clinical value.