Uamy/Ucr比值及尿胰蛋白酶原-2水平评估急性胰腺炎患者预后的临床价值

Clinical value of Uamy/Ucr ratio and urine trypsinogen-2 in evaluating the prognosis of patients with acute pancreatitis

目的探讨尿淀粉酶/尿肌酐(Uamy/Ucr)比值及尿胰蛋白酶原-2(TPS-2)水平对急性胰腺炎(AP)患者预后的评估价值。方法选取2019年3月—2021年5月在成都市第三人民医院收治的104例AP患者,根据其预后情况分为存活组(n=71)和死亡组(n=33)。比较两组患者的临床资料,采用化学比色法检测血清钙(Ca^(2+))水平,采用动脉血气分析仪检测动脉血氧分压(PaO_(2))水平,采用酶联免疫法检测Uamy和Ucr水平,采用免疫层析法检测尿TPS-2水平,应用受试者工作特征(ROC)曲线分析Uamy/Ucr比值和尿TPS-2对AP患者预后的预测价值。结果死亡组患者年龄、体质指数(BMI)、合并高血脂、Ca^(2+)和PaO_(2)水平与存活组比较差异有统计学意义(P<0.05);死亡组患者Uamy和Ucr均高于存活组(P<0.05);死亡组患者Uamy/Ucr比值和尿TPS-2阳性率分别为90.91%、93.94%,高于存活组的56.92%、53.52%(P<0.05)。ROC曲线分析显示,Uamy/Ucr比值、尿TPS-2及联合检测预测AP患者死亡的曲线下面积(AUC)分别为0.694、0.702、0.858(P<0.05)。结论AP患者预后与其年龄、血清Ca^(2+)和PaO_(2)水平有关。Uamy/Ucr比值及TPS-2水平对AP患者预后有较高的预测价值。

Objective To explore the evaluation value of urine amylase/urine creatinine(Uamy/Ucr)ratio and urine trypsinogen-2(TPS-2)for the prognosis of patients with acute pancreatitis(AP).Methods A total of 104 patients with AP admitted to the hospital were enrolled between March 2019 and May 2021.According to prognosis,they were divided into survival group(n=71)and death group(n=33).The clinical data in the two groups were collected and compared.The level of serum calcium(Ca^(2+))was detected by chemical colorimetry.The partial pressure of arterial oxygen(PaO_(2))was detected by arterial blood gas analyzer.The levels of Uamy and Ucr were detected by enzyme linked immunosorbent assay.The level of urine TPS-2 was detected by immunochromatographic assay.The predictive value of Uamy/Ucr ratio and urine TPS-2 for prognosis of AP patients was analyzed by receiver operating characteristic(ROC)curves.Results The differences in age,body mass index(BMI),hyperlipidemia,Ca^(2+)and PaO_(2) levels between death group and survival group were statistically significant(P<0.05).The levels of Uamy and Ucr in death group were higher than those in survival group(P<0.05).Uamy/Ucr ratio and positive rate of urine TPS-2 in death group were 90.91%and 93.94%,higher than those in survival group(56.92%,53.52%)(P<0.05).ROC curve analysis showed that the area under the curve(AUC)values of Uamy/Ucr ratio,urinary TPS-2 and combined detection for predicting death of AP patients were 0.694,0.702 and 0.858,respectively(P<0.05).Conclusion The prognosis of AP patients is related to age,serum Ca^(2+)and PaO_(2) levels.Uamy/Ucr ratio and TPS-2 level are of relatively higher predictive value for the prognosis of AP patients.