天津医药
天津醫藥
천진의약
TIANJIN MEDICAL JOURNAL
2015年
1期
61-63
,共3页
胰腺炎%急性病%C反应蛋白质%血尿素氮%纤维蛋白原%淀粉酶类%D-二聚体
胰腺炎%急性病%C反應蛋白質%血尿素氮%纖維蛋白原%澱粉酶類%D-二聚體
이선염%급성병%C반응단백질%혈뇨소담%섬유단백원%정분매류%D-이취체
pancreatitis%acute disease%C-reactive protein%blood urea nitrogen%fibrinogen%amylases%D-dimer
目的：探讨急性胰腺炎（AP）患者血钙、尿素氮（BUN）、D-二聚体、C-反应蛋白（CRP）、纤维蛋白原及淀粉酶水平与疾病严重程度的关系。方法114例AP患者中轻度AP（MAP组）70例，中度AP（MSAP组）18例，重度AP （SAP组）26例，比较各组实验室指标水平，并分析各指标与急性生理学与慢性健康评估系统Ⅱ（APACHEⅡ）评分的相关性；ROC曲线分析CRP、D-二聚体、纤维蛋白原诊断SAP的敏感性。结果 MSAP组、SAP组BUN、CRP、D-二聚体、纤维蛋白原和APACHEⅡ评分均高于MAP组，血钙低于MAP组；SAP组APACHEⅡ评分高于MSAP组（P＜0.05）；各组间血淀粉酶差异无统计学意义。APACHEⅡ评分与CRP、D-二聚体、纤维蛋白原呈正相关（r分别是0.407、0.404、0.245，均P＜0.05），与血钙呈负相关（r=-0.333，P＜0.05）。ROC曲线显示CRP诊断SAP曲线下面积最大为0.752（95%CI为0.644～0.860），cut-off值是74.45 mg/L，灵敏度为86.4%，特异度为68.2%。结论联合监测BUN、凝血指标、CRP、血钙等实验室指标，有助于综合评价AP患者的病情，改善患者的预后。
目的：探討急性胰腺炎（AP）患者血鈣、尿素氮（BUN）、D-二聚體、C-反應蛋白（CRP）、纖維蛋白原及澱粉酶水平與疾病嚴重程度的關繫。方法114例AP患者中輕度AP（MAP組）70例，中度AP（MSAP組）18例，重度AP （SAP組）26例，比較各組實驗室指標水平，併分析各指標與急性生理學與慢性健康評估繫統Ⅱ（APACHEⅡ）評分的相關性；ROC麯線分析CRP、D-二聚體、纖維蛋白原診斷SAP的敏感性。結果 MSAP組、SAP組BUN、CRP、D-二聚體、纖維蛋白原和APACHEⅡ評分均高于MAP組，血鈣低于MAP組；SAP組APACHEⅡ評分高于MSAP組（P＜0.05）；各組間血澱粉酶差異無統計學意義。APACHEⅡ評分與CRP、D-二聚體、纖維蛋白原呈正相關（r分彆是0.407、0.404、0.245，均P＜0.05），與血鈣呈負相關（r=-0.333，P＜0.05）。ROC麯線顯示CRP診斷SAP麯線下麵積最大為0.752（95%CI為0.644～0.860），cut-off值是74.45 mg/L，靈敏度為86.4%，特異度為68.2%。結論聯閤鑑測BUN、凝血指標、CRP、血鈣等實驗室指標，有助于綜閤評價AP患者的病情，改善患者的預後。
목적：탐토급성이선염（AP）환자혈개、뇨소담（BUN）、D-이취체、C-반응단백（CRP）、섬유단백원급정분매수평여질병엄중정도적관계。방법114례AP환자중경도AP（MAP조）70례，중도AP（MSAP조）18례，중도AP （SAP조）26례，비교각조실험실지표수평，병분석각지표여급성생이학여만성건강평고계통Ⅱ（APACHEⅡ）평분적상관성；ROC곡선분석CRP、D-이취체、섬유단백원진단SAP적민감성。결과 MSAP조、SAP조BUN、CRP、D-이취체、섬유단백원화APACHEⅡ평분균고우MAP조，혈개저우MAP조；SAP조APACHEⅡ평분고우MSAP조（P＜0.05）；각조간혈정분매차이무통계학의의。APACHEⅡ평분여CRP、D-이취체、섬유단백원정정상관（r분별시0.407、0.404、0.245，균P＜0.05），여혈개정부상관（r=-0.333，P＜0.05）。ROC곡선현시CRP진단SAP곡선하면적최대위0.752（95%CI위0.644～0.860），cut-off치시74.45 mg/L，령민도위86.4%，특이도위68.2%。결론연합감측BUN、응혈지표、CRP、혈개등실험실지표，유조우종합평개AP환자적병정，개선환자적예후。
Objective To investigate the relationship between values of blood calcium, serum urea nitrogen (BUN), D-dimer, C-reactive protein (CRP), fibrinogen and amylase with the severity of the disease in patients with acute pancreatitis (AP). Methods There were 70 patients with mild AP (MAP group), 18 patients with moderate AP (MSAP group), 26 pa?tients with severe acute pancreatitis (SAP group) in 114 AP patients. The laboratory indexes were compared between these groups. The correlation between indexes and the acute physiology and chronic health evaluation systemⅡ (APACHE Ⅱ) score was analysed. The diagnostic sensitivity of SAP using CRP, D-dimer and fibrinogen was analysed by ROC curves. Re?sults Compared with MAP group, values of BUN, CRP, D-dimer,fibrinogen and APACHEⅡscore were significantly increased in SAP group (P<0.05), but serum calcium level was significantly decreased (P<0.05). The APACHEⅡscore were significantly higher in SAP group than that of MSAP group (P<0.05). There were no significant differences in level of amylases between three groups. There was a positive correlation between APACHEⅡscore, CRP, D-dimer and fibrinogen (r=0.407, 0.404 and 0.245, P<0.05). There was a negative correlation between APACHEⅡscore and serum calcium level (r=-0.333, P<0.05). The area under the ROC curve showed a maximum CRP curve for diagnosing SAP 0.752 (95%CI=0.644-0.860). The cut-off value was 74.45 mg/L. The sensitivity was 86.4%. And the specificity was 68.2%. Conclusion Combining with monitoring BUN, blood coagulation index, CRP, serum calcium level and other laboratory parameters was useful to overall evaluate AP patients and improve the prognosis.
