血清降钙素原、淀粉酶、白蛋白和乳酸脱氢酶水平在急性重症胰腺炎临床诊断及病情评估中的作用

Value of serum procalcitonin,amylase,albumin and lactate dehydrogenase in the clinical diagnosis and evaluation of severe acute pancreatitis

目的探究血清降钙素原(PCT)、淀粉酶(AMY)、白蛋白(ALB)和乳酸脱氢酶(LDH)水平在急性重症胰腺炎临床诊断及病情评估中的作用。方法采用回顾性研究的方法,选择2020年1月1日至2022年12月31日就诊于盐城市第一人民医院的70例急性胰腺炎患者作为胰腺炎组,根据其病情严重程度分为轻症组(22例)和重症组(48例),并选取同期进行健康体检的70例患者作为对照组。收集所有研究对象入组时一般资料;检测受试者血清PCT、AMY、ALB和LDH水平;采用受试者工作特征(ROC)曲线分析各指标对急性重症胰腺炎的诊断价值及病情评估价值。结果胰腺炎组血清PCT、AMY、LDH水平显著高于对照组[(3.14±0.67)μg/L比(0.82±0.21)μg/L、(602.53±199.47)U/L比(99.97±30.85)U/L、(767.24±198.73)U/L比(423.61±59.19)U/L](P<0.05),胰腺炎组ALB水平显著低于对照组[(33.47±6.98)g/L比(45.79±6.12)g/L],差异有统计学意义(P<0.05);ROC曲线分析显示,PCT、AMY、LDH、ALB和联合检测诊断急性胰腺炎的曲线下面积(AUC)分别为0.783、0.792、0.697、0.732和0.915;轻症组急性胰腺炎患者血清PCT、LDH水平显著低于重症组[(2.76±0.44)μg/L比(3.59±0.61)μg/L、(507.06±131.67)U/L比(848.95±207.79)U/L](P<0.05),轻症组ALB水平显著高于重症组[(35.39±4.73)g/L比(32.64±5.09)g/L],差异有统计学意义(P<0.05);ROC曲线分析显示,PCT、LDH、ALB和联合检测评估患者病情严重程度的AUC分别为0.668、0.749、0.741和0.959。结论急性胰腺炎患者血清PCT、AMY、LDH水平异常升高,ALB水平异常降低,均可用来临床诊断,PCT、LDH、ALB可用来进行病情评估。

Objective To explore the value of serum procalcitonin(PCT),amylase(AMY),albumin(ALB)and lactate dehydrogenase(LDH)in the clinical diagnosis and evaluation of severe acute pancreatitis(SAP).Methods A total of 70 patients with acute pancreatitis treated in Yancheng First People′s Hospital from January 1,2020 to December 31,2022 were enrolled as pancreatitis group.According to disease severity,they were divided into mild group(22 cases)and severe group(48 cases).A total of 70 controls during the same period were enrolled as control group.The general data of all the objects were collected at enrollment.The levels of plasma PCT,AMY,ALB and LDH were detected.The diagnostic value of the above indexes for SAP and their evaluation value for disease severity were analyzed by receiver operating characteristic(ROC)curves.Results The levels of serum PCT,AMY and LDH in the pancreatitis group were significantly higher than those in the control group:(3.14±0.67)μg/L vs.(0.82±0.21)μg/L,(602.53±199.47)U/L vs.(99.97±30.85)U/L,(767.24±198.73)U/L vs.(423.61±59.19)U/L,P<0.05;while ALB was significantly lower than that in the control group:(33.47±6.98)g/L vs.(45.79±6.12)g/L,P<0.05.ROC curves analysis showed that area under the curve(AUC)values of PCT,AMY,LDH,ALB and combined detection in the diagnosis of acute pancreatitis were 0.783,0.792,0.697,0.732 and 0.915,respectively.The levels of serum PCT and LDH in the mild group were significantly lower than those in the severe group:(2.76±0.44)μg/L vs.(3.59±0.61)μg/L,(507.06±131.67)U/L vs.(848.95±207.79)U/L,P<0.05;while ALB was significantly higher than that in the severe group:(35.39±4.73)g/L vs.(32.64±5.09)g/L,P<0.05.ROC curves analysis showed that the AUC values of PCT,LDH,ALB and combined detection for evaluating disease severity were 0.668,0.749,0.741 and 0.959,respectively.The evaluation value of combined detection was significantly higher than that of single index(P<0.05).Conclusions The levels of serum PCT,AMY and LDH are abnormally increased,while ALB level is abnormally decreased in patients with acute pancreatitis,and which all can be applied for clinical diagnosis.PCT,LDH and ALB can be applied for disease evaluation.