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联合检测血清PCT、IL-6、CRP、AMY 及LPS对急性胰腺炎的诊断价值
王洋一,胡宏章,王军荐,胡凤姣,严薛丹,李松
0
(四川大学华西医院实验医学科;成都上锦南府医院)
摘要:
目的 通过检测急性胰腺炎(AP)患者外周血清降钙素原(PCT)、白细胞介素6(IL-6)、C反应蛋白(CRP)、淀粉酶(AMY)和脂肪酶(LPS)的水平,分析这5种血清指标联合检测在AP临床诊断中的价值。 方法 选取2015年1月~2017年1月在成都上锦南府医院确诊为急性胰腺炎患者117例为观察组,其中重症急性胰腺炎患者(SAP)62例,轻症急性胰腺炎患者(MAP)55例。另选取同期体检健康者110例为对照组。检测SAP者、MAP者和对照组血清中PCT、IL-6、CRP、AMY和LPS的浓度,并比较水平差异。 结果 SAP者及MAP者的PCT、IL-6、CRP、AMY和LPS水平均显著高于对照组(均P<0.05)。SAP者的PCT、IL-6、CRP水平均高于MAP者(P<0.05),而AMY、LPS水平比较,差异无统计学意义(P>0.05)。PCT、IL-6、CRP、AMY和LPS的ROC曲线面积分为0.72、0.87、0.84、0.88、0.86,灵敏度分别为为60.40%、71.80%、67.50%、70.90%、78.60%,特异度分别为82.70%、86.40%、90.90%、88.20%、85.50%。多种血清指标联合检测对AP诊断的曲线面积为0.97,灵敏度为86.80%,特异度为99.10%。 结论 血清PCT、IL-6、CRP、AMY及LPS指标联合检测对AP的诊断具有较高的敏感性和特异性,可有效提升AP患者的临床诊断准确率,可在临床推广、应用。
关键词:  降钙素原  白细胞介素 6  C 反应蛋白  淀粉酶  脂肪酶  急性胰腺炎
DOI:
基金项目:
Diagnostic value of serum PCT, IL-6, CRP, AMY and LPS for acute pancreatitis
WANG Yangyi,HU Hongzhang,WANG Junjian,HU Fengjiao,YAN Xuedan,LI Song
(Department of Laboratory Medicin, West China Hospital;Chengdu Shangjin Nanfu Hospital)
Abstract:
Objective To detect levels of peripheral serum procalcitonin (PCT), interleukin6 (IL-6), Creactive protein (CRP), amylase (AMY), and lipase (LPS) in patients with acute pancreatitis (AP) and analyze the value of combined detection of these five serum indicators in the clinical diagnosis of AP. Methods 117 patients with acute pancreatitis were enrolled in the hospital from January 2015 to January 2017, including 62 patients with severe acute pancreatitis (SAP) and 55 patients with mild acute pancreatitis (MAP). Another 110 healthy subjects were selected as the control group. The concentrations of PCT, IL-6, CRP, AMY and LPS in the serum of the SAP group, the MAP group and the control group were examined. The differences in serum PCT, IL-6, CRP, AMY and LPS levels were compared between groups. Using SPSS20.0 software for data analysis, the ROC curve was used to detect the serum value of the diagnosis of acute pancreatitis. Results The levels of PCT, IL-6, CRP, AMY and LPS in SAP group were significantly higher than those in the control group, and the difference was statistically significant (t values were 9.97, 12.95, 14.31, 15.38 and 8.83, P<0.01). The five serum indexes of patients in the MAP group were significantly higher than those in the control group, and the difference was statistically significant (t values were 9.32, 13.59 and 11.97, 13.43 and 11.27, P<0.01). The PCT, IL-6 and CRP levels were higher in the SAP group than in the MAP group. The difference was statisticallysignificant (tvalues were 4.43, 5.30 and 6.18, P<0.05), and the difference in AMY and LPS betweenthe two groups. Not statistically significant (t values were 0.994 and 0.409, respectively, P>0.05). The ROC curve areas of PCT, IL-6, CRP, AMY and LPS were 0.72, 0.87, 0.84, 0.88 and 0.86, and the sensitivity is 60.40%, 71.80%, 67.50%, 70.90% and 78.60%, and the specificity is 82.70%, 86.40%, 90.90%, 88.20%, 85.50%. The combined area of multiple serum indicators for the diagnosis of AP was 0.97, the sensitivity was 86.80%, and the specificity was 99.10%. Conclusion The detection of serum PCT, IL-6, CRP, AMY and LPS indicators has high sensitivity and specificity for the diagnosis of AP, which can effectively improve the clinical diagnosis accuracy of AP patients.
Key words:  Procalcitonin  Interleukin 6  C-reactive protein  Amylase  Lipase acute  Pancreatitis

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