中国实用医药
中國實用醫藥
중국실용의약
CHINA PRACTICAL MEDICAL
2014年
36期
1-3
,共3页
林琳%徐飞鹏%黄解元%许庆文%刘春安%黄哲%周才进%王玮尉
林琳%徐飛鵬%黃解元%許慶文%劉春安%黃哲%週纔進%王瑋尉
림림%서비붕%황해원%허경문%류춘안%황철%주재진%왕위위
肌酸激酶%C-反应蛋白%D-二聚体%绞窄性肠梗阻%早期诊断
肌痠激酶%C-反應蛋白%D-二聚體%絞窄性腸梗阻%早期診斷
기산격매%C-반응단백%D-이취체%교착성장경조%조기진단
Creatine kinase%C-reactive protein%D-dimer%Strangulated intestinal obstruction%Early diagnosis
目的：探讨血清肌酸激酶、C-反应蛋白和D-二聚体水平的测定在绞窄性肠梗阻早期诊断中的应用价值,以期为绞窄性肠梗阻的早期诊断提供依据。方法①在手术治疗前2h采集血液标本测定48例单纯性肠梗阻(单纯性肠梗阻组)和36例绞窄性肠梗阻(绞窄性肠梗阻组)患者的血清肌酸激酶、C-反应蛋白和D-二聚体水平,对照50例健康成年(正常对照组)的血清肌酸激酶、C-反应蛋白和D-二聚体水平。②比较在绞窄性肠梗阻组中15例未发生肠坏死者与48例(单纯性肠梗阻组)血清肌酸激酶、C-反应蛋白和D-二聚体水平。同时比较在绞窄性肠梗阻组中经手术证实的21例肠坏死者与15例未发生肠坏死者的血清肌酸激酶、C-反应蛋白和D-二聚体水平。应用相关性分析研究绞窄性肠梗阻患者的血清肌酸激酶、C-反应蛋白和D-二聚体三个指标之间的相关性。结果①单纯性肠梗阻组的血清肌酸激酶、C-反应蛋白和D-二聚体水平较正常对照组均无明显升高(P>0.05)。绞窄性肠梗阻组的血清肌酸激酶、C-反应蛋白和D-二聚体水平均较正常对照组及单纯性肠梗阻组明显升高(P<0.001)。②在绞窄性肠梗阻组中无肠坏死者血清肌酸激酶、C-反应蛋白和D-二聚体水平均高于(单纯性肠梗阻组)(分别为P<0.05, P<0.001, P<0.001)。③在绞窄性肠梗阻组中已有肠坏死者血清肌酸激酶、C-反应蛋白和D-二聚体水平均高于无肠坏死者(分别为P<0.005, P<0.001, P<0.05)。④绞窄性肠梗阻患者的血清肌酸激酶、C-反应蛋白和D-二聚体三个血清学指标之间相互呈正相关(分别为：r=0.8211, r=0.8546, r=0.6497；均P<0.001)。结论肠梗阻患者血清肌酸激酶、C-反应蛋白和D-二聚体水平的测定值不仅可以对肠绞窄的早期诊断提供依据,还可以用来判断肠绞窄损伤的程度,而三者的综合测定则对绞窄性肠梗阻早期诊断的临床应用价值更大。
目的：探討血清肌痠激酶、C-反應蛋白和D-二聚體水平的測定在絞窄性腸梗阻早期診斷中的應用價值,以期為絞窄性腸梗阻的早期診斷提供依據。方法①在手術治療前2h採集血液標本測定48例單純性腸梗阻(單純性腸梗阻組)和36例絞窄性腸梗阻(絞窄性腸梗阻組)患者的血清肌痠激酶、C-反應蛋白和D-二聚體水平,對照50例健康成年(正常對照組)的血清肌痠激酶、C-反應蛋白和D-二聚體水平。②比較在絞窄性腸梗阻組中15例未髮生腸壞死者與48例(單純性腸梗阻組)血清肌痠激酶、C-反應蛋白和D-二聚體水平。同時比較在絞窄性腸梗阻組中經手術證實的21例腸壞死者與15例未髮生腸壞死者的血清肌痠激酶、C-反應蛋白和D-二聚體水平。應用相關性分析研究絞窄性腸梗阻患者的血清肌痠激酶、C-反應蛋白和D-二聚體三箇指標之間的相關性。結果①單純性腸梗阻組的血清肌痠激酶、C-反應蛋白和D-二聚體水平較正常對照組均無明顯升高(P>0.05)。絞窄性腸梗阻組的血清肌痠激酶、C-反應蛋白和D-二聚體水平均較正常對照組及單純性腸梗阻組明顯升高(P<0.001)。②在絞窄性腸梗阻組中無腸壞死者血清肌痠激酶、C-反應蛋白和D-二聚體水平均高于(單純性腸梗阻組)(分彆為P<0.05, P<0.001, P<0.001)。③在絞窄性腸梗阻組中已有腸壞死者血清肌痠激酶、C-反應蛋白和D-二聚體水平均高于無腸壞死者(分彆為P<0.005, P<0.001, P<0.05)。④絞窄性腸梗阻患者的血清肌痠激酶、C-反應蛋白和D-二聚體三箇血清學指標之間相互呈正相關(分彆為：r=0.8211, r=0.8546, r=0.6497；均P<0.001)。結論腸梗阻患者血清肌痠激酶、C-反應蛋白和D-二聚體水平的測定值不僅可以對腸絞窄的早期診斷提供依據,還可以用來判斷腸絞窄損傷的程度,而三者的綜閤測定則對絞窄性腸梗阻早期診斷的臨床應用價值更大。
목적：탐토혈청기산격매、C-반응단백화D-이취체수평적측정재교착성장경조조기진단중적응용개치,이기위교착성장경조적조기진단제공의거。방법①재수술치료전2h채집혈액표본측정48례단순성장경조(단순성장경조조)화36례교착성장경조(교착성장경조조)환자적혈청기산격매、C-반응단백화D-이취체수평,대조50례건강성년(정상대조조)적혈청기산격매、C-반응단백화D-이취체수평。②비교재교착성장경조조중15례미발생장배사자여48례(단순성장경조조)혈청기산격매、C-반응단백화D-이취체수평。동시비교재교착성장경조조중경수술증실적21례장배사자여15례미발생장배사자적혈청기산격매、C-반응단백화D-이취체수평。응용상관성분석연구교착성장경조환자적혈청기산격매、C-반응단백화D-이취체삼개지표지간적상관성。결과①단순성장경조조적혈청기산격매、C-반응단백화D-이취체수평교정상대조조균무명현승고(P>0.05)。교착성장경조조적혈청기산격매、C-반응단백화D-이취체수평균교정상대조조급단순성장경조조명현승고(P<0.001)。②재교착성장경조조중무장배사자혈청기산격매、C-반응단백화D-이취체수평균고우(단순성장경조조)(분별위P<0.05, P<0.001, P<0.001)。③재교착성장경조조중이유장배사자혈청기산격매、C-반응단백화D-이취체수평균고우무장배사자(분별위P<0.005, P<0.001, P<0.05)。④교착성장경조환자적혈청기산격매、C-반응단백화D-이취체삼개혈청학지표지간상호정정상관(분별위：r=0.8211, r=0.8546, r=0.6497；균P<0.001)。결론장경조환자혈청기산격매、C-반응단백화D-이취체수평적측정치불부가이대장교착적조기진단제공의거,환가이용래판단장교착손상적정도,이삼자적종합측정칙대교착성장경조조기진단적림상응용개치경대。
Objective To investigate the application value of serum creatine kinase, C-reactive protein and D-dimer detection in early diagnosis of strangulated intestinal obstruction, in order to provide reference for early diagnosis of strangulated intestinal obstruction. Methods ①The levels of serum creatine kinase, C-reactive protein and D-dimer were detected in 2 h before surgery by blood preparation of 48 simple intestinal obstruction patients (simple intestinal obstruction group) and 36 strangulated intestinal obstruction patients (strangulated intestinal obstruction group). These were compared with the levels of serum creatine kinase, C-reactive protein and D-dimer of 50 healthy adults (normal control group). ②The levels of serum creatine kinase, C-reactive protein and D-dimer were compared between 15 strangulated intestinal obstruction cases without intestinal necrosis in the strangulated intestinal obstruction group and 48 cases in the simple intestinal obstruction group. These indexes were also compared between 21 strangulated intestinal obstruction cases with intestinal necrosis and 15 cases without intestinal necrosis in the strangulated intestinal obstruction group. The correlation between the indexes of serum creatine kinase, C-reactive protein and D-dimer in strangulated intestinal obstruction patients was analyzed by correlation analysis. Results ①The levels of serum creatine kinase, C-reactive protein and D-dimer were not obviously increased in simple intestinal obstruction group, compared with those in the normal control group (P>0.05), while those of the strangulated intestinal obstruction group were significantly higher than the normal control group (P<0.001).②The levels of serum creatine kinase, C-reactive protein and D-dimer were higher in the strangulated intestinal obstruction cases without intestinal necrosis than normal control cases (P<0.05, P<0.001, P<0.001).③The levels of serum creatine kinase, C-reactive protein and D-dimer were higher in the strangulated intestinal obstruction cases with intestinal necrosis than those without intestinal necrosis (P<0.005,P<0.001, P<0.05). ④There were positive correlations between the three indexes of serum creatine kinase, C-reactive protein and D-dimer in strangulated intestinal obstruction patients (r=0.8211, r=0.8546, r=0.6497, all P<0.001). Conclusion The detection of levels of serum creatine kinase, C-reactive protein and D-dimer can not only provide reference for early diagnosis of strangulated intestinal obstruction, but also be used as judgment of degree of intestinal strangulation injury. The combination detection of the three indexes has more clinical application value for early diagnosis of strangulated intestinal obstruction.
