CAJ | 학술논문

目的探讨甲状腺激素对急性胰腺炎疾病严重程度早期评判的价值.方法前瞻性收集52例急性胰腺炎(重症32例、轻症20例)患者的临床资料.疾病严重程度根据亚特兰大标准分为32例重症(SAP)和20例轻症急性胰腺炎(MAP).检测入院时患者的甲状腺激素水平(FT4、FT3、rT3、TSH).比较甲状腺激素水平的组间差异,分析甲状腺激素水平与APACHEⅡ评分及Balthazar CT分级的关系,并采用受试者工作特征(ROC)曲线评价甲状腺激素预测疾病严重程度的有效性.结果 SAP组血清FT3水平明显低于MAP组(P＜0.01)；而FT4、rT3和TSH水平组间差异无统计学意义(P＞0.05).血清ET3水平与APACHEⅡ评分及Balthazar CT分级呈显著性负相关(分别为r=-0.687,P＜0.01；r=-0.720,P＜0.01).FT3的ROC曲线下面积为0.875.采用优选的分界点2.87 pmol/L,FT3预测重症胰腺炎灵敏度、特异度、阳性预测值和阴性预测值分别为75％,95％,93.8％和79.2％.结论血清FT3水平可以作为早期评判急性胰腺炎严重程度的指标.
목적 탐토갑상선격소대급성이선염질병엄중정도조기평판적개치.방법 전첨성수집52례급성이선염(중증32례、경증20례)환자적림상자료.질병엄중정도근거아특란대표준분위32례중증(SAP)화20례경증급성이선염(MAP).검측입원시환자적갑상선격소수평(FT4、FT3、rT3、TSH).비교갑상선격소수평적조간차이,분석갑상선격소수평여APACHEⅡ평분급Balthazar CT분급적관계,병채용수시자공작특정(ROC)곡선평개갑상선격소예측질병엄중정도적유효성.결과 SAP조혈청FT3수평명현저우MAP조(P＜0.01)；이FT4、rT3화TSH수평조간차이무통계학의의(P＞0.05).혈청ET3수평여APACHEⅡ평분급Balthazar CT분급정현저성부상관(분별위r=-0.687,P＜0.01；r=-0.720,P＜0.01).FT3적ROC곡선하면적위0.875.채용우선적분계점2.87 pmol/L,FT3예측중증이선염령민도、특이도、양성예측치화음성예측치분별위75％,95％,93.8％화79.2％.결론 혈청FT3수평가이작위조기평판급성이선염엄중정도적지표.
Objective To explore the value of serum thyroid hormones in assessing the severity of acute pancreatitis early in its course.Methods Fifty-two patients with acute pancreatitis were included in this prospective study.Attacks were classified as severe ( n =32) or mild ( n =20) according to the Atlanta criteria.Serum levels of thyroid hormones,including FT4,FT3,rT3 and TSH,were measured at admission.Each of the thyroid hormone levels was compared between the severe and mild groups,and the relationships of these thyroid hormones with APACHE Ⅱ scores and CT severity grading were analyzed.Effectiveness of thyroid hormone for the prediction of disease severity was evaluated by receiver operating characteristic (ROC) curve analysis.Results Serum FT3 levels were decreased significantly in severe acute pancreatitis compared with those in mild acute pancreatitis (P ＜ 0.01 ) ; whereas no significant difference was noted in the levels of FT4,rT3 and TSH between groups (P ＞ 0.05 ).Serum FT3 levels were negatively correlated with APACHE Ⅱ scores ( r =- 0.687,P ＜ 0.01 ) and CT severity grading ( r =- 0.720,P ＜ 0.01 ).The area under curve of FT3 was 0.875.With an optimum cutoff value of 2.87 pmol/L for FT3,the sensitivity,specificity,positive predictive and negative predictive values for the prediction of severe acute pancreatitis were 75％,95％,93.8％,and 79.2％,respectively.Conclusions Serum FT3 level is an acceptable indicator for early assessment of the severity of acute pancreatitis.