血清炎性标记物对急性胰腺炎严重程度预测的研究进展

Research Progress of Serum Inflammatory Markers in Predicting the Severity of Acute Pancreatitis

急性胰腺炎是临床外科常见的急腹症之一,具有较高的致死率,早期评估急性胰腺炎的严重程度至关重要。在急性胰腺炎严重程度评估中,Ranson等临床评分不够精准,受抽样误差影响。多层螺旋CT等影像学诊断时效具有滞后性,早期不能较为精准反映急性胰腺炎缺血坏死程度。而血清生物标志物具有早期、快速、便捷等优点,在临床实践中得到广泛应用。目前C反应蛋白(CRP)、降钙素原(PCT)、白细胞介素-6 (IL-6)、红细胞分布宽度(RDW)等已被临床广泛证实用于急性胰腺炎严重程度的早期预测,近几年发现一些新兴的血清炎性标志物,如中性粒细胞/淋巴细胞比率(NLR)、血小板计数/淋巴细胞比率(PLR)、同型半胱氨酸(Hcy)、血管生成素2 (Ang2)等用于评估急性胰腺炎(AP)的严重程度,本文就血清炎性标记物对急性胰腺炎严重程度的早期预测研究进展作一综述。为急性胰腺炎的诊疗提供参考依据。

Acute pancreatitis is one of the common acute abdomen in clinical surgery, which has a high mortality. Early assessment of the severity of acute pancreatitis is very important. In the evaluation of the severity of acute pancreatitis, Ranson and other clinical scores are not accurate enough, which is affected by sampling errors. The imaging diagnosis of multi-slice spiral CT and other imaging diagnosis has a lag, which can not accurately reflect the degree of ischemic necrosis of acute pancreatitis in the early stage. Serum biomarkers have the advantages of early, rapid and convenient, and have been widely used in clinical practice. At present, C-reactive protein (CRP), Procalcitonin (PCT), Interleukin-6 (IL-6) and Erythrocyte distribution width (RDW) have been widely used in the early prediction of the severity of acute pancreatitis. In recent years, some new serum inflammatory markers, such as Neutrophil/lymphocyte ratio (NLR), Platelet count/lymphocyte ratio (PLR), Homocysteine (Hcy) and Angiopoietin-2 (Ang2), have been found to evaluate the severity of acute pancreatitis (AP). This article reviews the research progress of serum inflammatory markers in early prediction of the severity of acute pancreatitis to provide reference basis for the diagnosis and treatment of acute pancreatitis.