重症急性胰腺炎的血浆TFPI水平和诊断价值

发布时间：2018-07-01 21:25

  本文选题：急性胰腺炎 + 重症　； 参考：《军事医学》2015年08期

【摘要】：目的检测急性胰腺炎(acute pancreatitis,AP)患者血浆组织因子途径抑制剂(tissue factor pathway inhibitor,TFPI)水平,并评价其诊断重症急性胰腺炎(severe acute pancreatitis,SAP)的临床价值。方法取68名急性胰腺炎患者,包括SAP患者32例,轻型急性胰腺炎(mild acute pancreatitis,MAP)患者36例;另取同期门诊体检者20例为对照,均入院1 h内抽血样,收集临床及实验室参数,计算APACHEⅡ评分和Ranson评分;采用酶联免疫吸附测定(ELISA)方法检测血浆TFPI水平。结果 MAP组患者血浆TFPI浓度[(3026.81±465.76)pg/ml]较对照组明显升高[(2468.73±262.39)pg/ml](P0.05),SAP患者血浆TFPI浓度[(4274.25±639.83)pg/ml]较MAP组明显升高(P0.05)。相关分析显示,AP患者的血浆TFPI水平与白细胞计数(WBC)、天冬氨酸转氨酶(AST)、丙氨酸转氨酶(ALT)、总胆红素(TBIL)、肌酐(Cr)、凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、降钙素原(PCT)、APACHEⅡ评分和Ranson评分呈显著正相关(P0.05),与PLT呈显著负相关(P0.05)。ROC曲线图分析显示,血浆TFPI水平诊断SAP发生的价值AUCSAP=0.902,95%CI=0.845~0.959(P0.05),诊断界值为血浆TFPI浓度4028.83 pg/ml时,敏感度为87%,特异度为78%。结论 SAP患者的血浆TFPI水平可较正常人群和MAP患者显著升高,并与胰腺炎危重程度显著相关,可用于诊断SAP。
[Abstract]:Objective to detect the level of plasma tissue factor pathway inhibitor (tissue factor pathway inhibitor TFPI in patients with acute pancreatitis (AP) and to evaluate its clinical value in the diagnosis of severe acute pancreatitis (SAP). Methods Sixty-eight patients with acute pancreatitis, including 32 patients with acute pancreatitis and 36 patients with mild acute pancreatitis (map), and 20 patients with physical examination in the same period were taken as control. Blood samples were taken from all patients within 1 hour after admission, and the clinical and laboratory parameters were collected. Apache 鈪，

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