多层螺旋CT联合降钙素原、动静脉血二氧化碳分压差对急性胰腺炎严重程度的早期评估价值

The value of multi-slice spiral CT combined with procalcitonin and pressure(central venous-arterial)carbon dioxide in early assessment of acute pancreatitis severity

目的探讨多层螺旋CT(MSCT)联合降钙素原(PCT)与中心静脉-动脉血二氧化碳分压差[P(cv-a)CO_(2)]在急性胰腺炎(AP)严重程度早期评估中的价值。方法选取2019年8月至2021年8月丰城市人民医院收治的129例AP患者作为研究对象,所有患者均经病理检查确诊,其中重症急性胰腺炎(SAP)62例为SAP组,轻症急性胰腺炎(MAP)67例为MAP组,同时选取同期于丰城市人民医院体检的116例健康体检者为对照组。所有受试者均行MSCT、PCT、P(cv-a)CO_(2)检测。比较三组的PCT、P(cv-a)CO_(2)水平;以病理检查为诊断金标准,分析MSCT、PCT、P(cv-a)CO_(2)单独检测以及联合检测在AP中的诊断效能。结果SAP组的PCT、P(cv-a)CO_(2)水平高于MAP组与对照组,MAP组的PCT、P(cv-a)CO_(2)水平高于对照组,差异有统计学意义(P<0.05);MSCT、PCT、P(cv-a)CO_(2)联合检测的灵敏度和准确度均高于三项指标单独检测,差异有统计学意义(P<0.05)。结论MSCT联合PCT与P(cv-a)CO_(2)可有效评估AP患者病情严重程度,对于早期诊断AP具有较高的应用价值,临床可推广使用。

Objective To explore the value of multi-slice spiral CT(MSCT)combined with procalcitonin(PCT)and pressure(central venous-arterial)carbon dioxide(P[cv-a]CO_(2))in early assessment of acute pancreatitis(AP)severity.Methods A total of 129 AP patients admitted to Fengcheng People's Hospital from August 2019 to August 2021 were selected as the study subjects,all patients were confirmed through pathological examination,among them 62 cases of severe acute pancreatitis(SAP)were included in the SAP group,67 cases of mild acute pancreatitis(MAP)were included in the MAP group,at the same time,116 healthy individuals who underwent physical examinations at Fengcheng People's Hospital were selected as the control group.All subjects underwent MSCT,PCT and P(cv-a)CO_(2) testing.The levels of PCT and P(cv-a)CO_(2) in three groups were compared.Pathological examination was used as the diagnostic gold standard,the diagnostic efficacy of MSCT,PCT,P(cv-a)CO_(2) detection alone and combined detection in AP were analyzed.Results The levels of PCT and P(cv-a)CO_(2) in the SAP group were higher than those in the MAP group and control group,the levels of PCT and P(cv-a)CO_(2) in the MAP group were higher than those in the control group,the differences were statistically significant(P<0.05).The sensitivity and accuracy of the combined detection of MSCT,PCT,and P(cv-a)CO_(2) were all higher than those of the three indicators tested separately,the differences were statistically significant(P<0.05).Conclusion MSCT combined with PCT and P(cv-a)CO_(2) can effectively evaluate the severity of AP patients and has high application value for early diagnosis of AP.It can be widely used in clinical practice.