血清降钙素原和可溶性髓样细胞触发受体-1对急性胰腺炎患者病情的预测效果

发布时间：2018-08-01 18:34

【摘要】：目的探讨血清降钙素原(PCT)和可溶性髓样细胞触发受体-1(s TREM-1)对急性胰腺炎(AP)患者病情严重程度的预测价值。方法选取80例AP患者,其中轻症急性胰腺炎患者38例(轻症组)和重症急性胰腺炎患者42例(重症组);同期选取查体健康个体40例(对照组)。检测AP患者入院第1、3及7天的s TREM-1和PCT浓度,并记录血淀粉酶、血钙、血糖及C-反应蛋白浓度。同时,进行CT严重度指数(CTSI)评分、床旁急性胰腺炎严重度(BISAP)评分、急性生理与慢性健康状况评分(APACHE II)。统计学分析AP患者入院第1、3及7天的s TREM-1和PCT浓度变化和ROC曲线下面积(AUC)判断各观察指标对急性胰腺炎的诊断效能。结果 1重症组的住院天数(14.94±7.23)vs(8.22±4.31)d、CTSI评分(5.64±2.55)vs(3.23±1.12)、BISAP评分(3.34±1.62)vs(1.41±0.73)、APACHE II评分(11.55±7.87)vs(6.42±4.21),明显高于轻症组,P0.05。2重症组的s TREM-1[(0.46±0.28)vs(0.31±0.20),(0.21±0.16)ng/ml)]、PCT浓度[(4.62±1.67)vs(0.67±0.12),(0.10±0.01)ng/ml)],显著高于轻症组和对照组,P0.05;轻症组的s TREM-1和PCT浓度显著高于对照组,P0.05。3重症组患者入院第1、3及7天的s TREM-1(0.46±0.28)vs(0.31±0.20);(0.40±0.17)vs(0.27±0.11);0.31±0.14)vs(0.25±0.09)ng/ml、PCT浓度(4.62±1.67)vs(0.67±0.12);(3.52±1.07)vs(0.49±0.10);(1.94±0.86)vs(0.31±0.09)ng/ml,均高于轻症组,P0.05。而且两组的s TREM-1和PCT浓度入院7 d内均呈递减趋势。4对AP患者严重程度诊断效能较大的是PCT浓度(敏感度为96.8%,特异度为97.6%,AUC=0.972),其次是APACHE II评分(敏感度为90.4%,特异度为92.8%,AUC=0.916)和s TREM-1浓度(敏感度为88.1%,特异度为90.3%,AUC=0.892)。结论 AP患者s TREM-1和PCT浓度变化与AP的病情严重程度有关,能够预测AP的病情变化。
[Abstract]:Objective to investigate the value of serum procalcitonin (PCT) and soluble myeloid cell trigger receptor 1 (s TREM-1) in predicting the severity of (AP) in patients with acute pancreatitis. Methods A total of 80 patients with AP were selected, including 38 patients with mild acute pancreatitis (mild pancreatitis) and 42 patients with severe acute pancreatitis (severe group), and 40 healthy individuals (control group). S TREM-1 and PCT were measured on the 3rd and 7th day after admission, and serum amylase, calcium, blood glucose and C-reactive protein were recorded. At the same time, CT severity index (CTSI) score, bedside acute pancreatitis severity (BISAP) score, acute physiology and chronic health score (APACHE II).) were evaluated. The changes of s TREM-1 and PCT concentrations on the 3rd and 7th day after admission and the area under ROC curve (AUC) were analyzed statistically to evaluate the diagnostic efficacy of the observed indexes for acute pancreatitis. 缁撴灉 1閲嶇棁缁勭殑浣忛櫌澶╂暟(14.94卤7.23)vs(8.22卤4.31)d,CTSI璇勫垎(5.64卤2.55)vs(3.23卤1.12),BISAP璇勫垎(3.34卤1.62)vs(1.41卤0.73),APACHE II璇勫垎(11.55卤7.87)vs(6.42卤4.21),鏄庢樉楂樹簬杞荤棁缁，

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