慢性肾病合并急性胰腺炎血淀粉酶水平分析

发布时间：2018-07-12 22:04

本文选题：急性胰腺炎 + 慢性肾病　；参考：《山西医科大学》2017年硕士论文

【摘要】：目的:探讨血淀粉酶对诊断慢性肾病患者合并急性胰腺炎时的价值和可靠性。方法:本研究采用的是回顾性调查分析,病例收集于山西医科大学第一、第二附属医院及山西省人民医院。病例纳入标准:慢性肾病史的急性胰腺炎患者,就诊时合并腹痛或腹部不适的普通慢性肾病患者,以及不合并慢性肾病的急性胰腺炎患者,所有病例入院后均行腹部超声或腹部CT检查确诊或排除急性胰腺炎诊断,慢性肾病患者在本次入院前已获得临床诊断。依次分为CKD+AP组、CKD组、AP组。收集各组病人的一般资料及临床资料,在各组之间进行统计学分析。结果:在CKD+AP组和AP组比较中,两组血淀粉酶水平分别为655.7±414.3和621.1±299.4,诊断的敏感性分别为77.8%和85.7%,两组数据差别无统计学意义。CKD组的血淀粉酶为246.0±116.4,与CKD+AP组相比存在统计学差异,结合两组数据,血淀粉酶诊断的特异性为81.6%。将高于参考值4倍作为诊断标准,血淀粉酶的特异性可升高到93.9%,但敏感性则下降到61.1%,漏诊率为38.9%。比较CKD组患者AMY与CREA的相关性,相关系数为0.769,存在显著的正相关。结论:血淀粉酶对诊断慢性肾病合并急性胰腺炎的价值有限,尤其是肾功能损害较为严重、血清肌酐水平较高的患者。
[Abstract]:Objective: to investigate the value and reliability of serum amylase in the diagnosis of chronic nephropathy complicated with acute pancreatitis. Methods: the cases were collected from the first and second affiliated hospitals of Shanxi Medical University and the people's Hospital of Shanxi Province. Inclusion criteria: patients with acute pancreatitis with a history of chronic nephropathy, patients with common chronic nephropathy with abdominal pain or abdominal discomfort at the time of treatment, and patients with acute pancreatitis without chronic nephropathy, The diagnosis of acute pancreatitis was confirmed or excluded by abdominal ultrasound or CT examination after admission, and the clinical diagnosis was obtained in patients with chronic nephropathy before admission. They were divided into CKD AP group and CKD group AP group in turn. The general and clinical data of patients in each group were collected and analyzed statistically. Results: the serum amylase levels of the two groups were 655.7 卤414.3 and 621.1 卤299.4, respectively. The diagnostic sensitivity was 77.8% and 85.7%, respectively. There was no significant difference between the two groups. The serum amylase levels in the CKD group were 246.0 卤116.4, which were significantly different from those in the CKD AP group. Combined with two groups of data, the specificity of diagnosis of serum amylase was 81.6%. The specificity of serum amylase was increased to 93.9, but the sensitivity decreased to 61.1, and the missed diagnosis rate was 38.9. Compared the correlation between Amy and CREA in CKD group, the correlation coefficient was 0.769, there was significant positive correlation. Conclusion: serum amylase is of limited value in the diagnosis of chronic nephropathy complicated with acute pancreatitis, especially in patients with severe renal function damage and high serum creatinine level.
【学位授予单位】：山西医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R692;R576

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