Objective: To determine the early predictive value of com- ? Bined detection of serum calcium and C-reaction protein (CRP) for estimating the severity of acute pancreatitis (AP). Methods-.The serum calcium and CRP were monitored at day 1,2 and 3, respectively, in 52 patients with mild acute pancreatitis (MAP) and another 21 with severe a-cute pancreatitis (SAP) for comparing the trend of variation of the two indicators. Results: The levels of serum CRP were increased significantly in AP patients at the the first day of admission and peaked at day 2, and the increase appreared prominent in SAP patients as compared with those of MAP( P < 0. 001). The diagnostic sensitivity of CRP, specificity and AUC were 85.7% ,94. 2% and 0.904,respectively. The serum calcium concentration had no visible difference between the two groups ( P > 0.05), and yet, the levels in SAP patients were decreased notablely at the first day of hospital admission( P < 0.01) and fuller down regulated with time forward. Plain diagnostic sensitivity of serum calcium, specificity and AUC was 76.2% ,96. 1% and 0. 874, respectively. Combined detection of the two indicators could boost the sensitivity, specificity and disgnositic index to respectively 95.2% ,92. 3% and 1. 88. Conclusion: The com-bined detection of serum calcium and CRP are helpful to estimate the theseveritv of acute pancreatitis.%目的:探讨联合检测血清钙和C反应蛋白(CRP)对急性胰腺炎(AP)严重程度的早期预测价值.方法:回顾分析我院52例轻型急性胰腺炎(MAP)和21例重症急性胰腺炎(SAP)患者发病早期血清钙和C反应蛋白的变化规律,并对这两项指标预测SAP的诊断价值进行评估.结果:入院第1天AP病人血清CRP水平即明显增高,第2天达高峰,SAP组比MAP组增幅更为显著(P＜0.001):此时CRP诊断SAP的灵敏度、特异度和ROC曲线下面积分别为85.7％、94.2％、0.904.与正常对照组比较,MAP组患者血清钙无明显变化(P＞0.05),而SAP组患者入院第1天血清钙水平即显著降低(P＜0.01),随着时间推移,血清钙水平继续下降；血清钙诊断SAP的灵敏度、特异度和ROC曲线下面积分别为76.2％、96.1％、0.874.联合检测血清钙和CRP诊断SAP的灵敏度、特异度和诊断指数分别为95.2％、92.3％、1.88.结论:血清钙和CRP联合检测对急性胰腺炎的危重程度有可靠的预测价值.
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