不同严重程度急性胰腺炎患者血清中PCT、hs-CRP、TNF-α水平及临床意义

Expression and Clinical Significance of Serum PCT, hs-CRP and TNF-αin Patients with Different Severity of Acute Pancreatitis

目的:探讨降钙素原(PCT)、超敏C反应蛋白(hs-CRP)、肿瘤坏死因子-α(TNF-α)在轻症、重症急性胰腺炎(AP)患者血清中的表达水平及临床意义。方法:选取我院在2016年1月~2018年7月期间收治的AP患者108例进行研究,并记为AP组,其中轻症急性胰腺炎(MAP)患者58例纳入MAP组,重症急性胰腺炎(SAP)患者50例纳入SAP组,另选取同期在我院进行体检的50例健康体检者作为对照组。AP组患者于入院第1 d、3 d、7 d、14 d采用酶联免疫吸附试验(ELISA)检测血清中PCT、hs-CRP、TNF-α水平,对照组仅在体检时检测血清中PCT、hs-CRP、TNF-α水平。将AP组患者分为全身炎症反应综合征(SIRS)组和非SIRS组,比较SIRS组和非SIRS组血清中PCT、hs-CRP、TNF-α水平的差异。采用Spearman相关性分析AP患者入院第1 d的血清PCT、hs-CRP、TNF-α水平的相关性。结果:与对照组比较,AP组患者入院第1d血清PCT、hs-CRP、TNF-α水平升高(P<0.05)。入院第1 d、3 d、7 d、14 d时SAP组患者的血清PCT、hs-CRP、TNF-α水平均高于MAP组患者(P<0.05),SAP组患者各指标在第3 d达到峰值,此后依次降低,而MAP组患者各指标随入院时间的延长持续降低。SIRS组患者入院第1d的血清PCT水平高于非SIRS组患者(P<0.05),而两组血清hs-CRP、TNF-α水平比较差异无统计学意义(P>0.05)。经Spearman相关性分析显示,AP患者入院第1 d的血清PCT、hs-CRP、TNF-α水平互为正相关关系(P<0.05)。结论:AP患者血清中PCT、hs-CRP、TNF-α水平偏高,与病情严重程度密切相关,且三指标之间呈正相关,检测血清PCT、hs-CRP、TNF-α可为该病诊断、病情评估、疗效评估提供依据。

Objective:To investigate the expression and significance of serum procalcitonin(PCT),hypersensitive C-reactive protein(hs-CRP)and tumor necrosis factor-α(TNF-α)in mild and severe acute pancreatitis(AP).Methods:108 patients with AP who were treated in our hospital from January 2016 to July 2018 were selected,and they were recorded as AP group.Among them,58 patients with mild acute pancreatitis(MAP)were included in MAP group,50 patients with severe acute pancreatitis(SAP)were included in SAP group.Another 50 healthy persons who underwent physical examination in our hospital during the same period were selected as control group.The levels of serum PCT,hs-CRP and TNF-αwere detected by enzyme-linked immunosorbent assay(ELISA)at the 1 d,3 d,7 d and 14 d after admission in AP group.The levels of serum PCT,hs-CRP and TNF-αin the control group were measured only at the time of physical examination.Patients in AP group were divided into systemic inflammatory response syndrome(SIRS)group and non SIRS group.The differences of serum PCT,hs-CRP and TNF-αlevels between the two groups were compared.Spearman correlation analysis was used to analyze the correlation of PCT,hs-CRP and TNF-αlevels in patients with AP at 1 d of admission.Results:The levels of serum PCT,hs-CRP and TNF-αat 1 d of admission in AP group were higher than those in the control group(P<0.05).The levels of serum PCT,hs-CRP and TNF-αin SAP group were higher than those in MAP group at 1 d,3 d,7 d and 14 d after admission(P<0.05).The indexes of SAP group were reached the peak at 3 d,and then they were decreased in turn.After treatment,the indexes of MAP group were continued to decrease with the increase of admission time.The level of serum PCT in group SIRS at 1 d of admission was higher than that in non SIRS group(P<0.05).There was no significant difference in the levels of serum hs-CRP and TNF-αbetween the two groups(P>0.05).Spearman correlation analysis showed that the levels of serum PCT,hs-CRP and TNF-αin patients with AP at 1 d of admission were positively correlated with each other(P<0.05).Conclusion:The levels of serum PCT,hs-CRP and TNF-αin patients with AP were highly expressed.They are closely related to the severity of the disease,and there is a positive correlation between the three indicators,detection of serum PCT,hs-CRP and TNF-αcan provide a basis for the diagnosis of the disease,disease judgment,efficacy evaluation.