血清淀粉酶、血清胰蛋白酶原－2、IL－10及PAF联合检测对ERCP术后胰腺炎的诊断价值

摘要

Objective To evaluate the expression of serum amylase, trypsinogen-2, interleukin-10 (IL-10) and platelet activating factor (PAF) in post-ERCP pancreatitis (PEP) patients, and their diagnostic value of combined detection in the diagnosis of PEP. Methods 120 cases of ERCP patients were divided into control group(60 cases) and PEP group(60 cases) in our hospital from August 2012 to November 2013. Serum amylase, trypsinogen-2, IL-10 and PAF levels before operation, 4 h after surgery and postoperative 24 h in the two groups were detected by Johnson&johnson Vitros-350 automatic chemical and biochemical analyzer , and the test results were statistically analyzed. Results In patients with PEP, 4 h after surgery and postopera-tive 24 h serum amylase, trypsinogen-2, IL-10 and PAF levels were all higher than those of before operation and 4 h after surgery and postoperative 24 h in control group, and the differences all had statistical significance (Pall<0.05). The highest level of serum amylase in PEP group was postoperative 24 h, and the highest levels of trypsinogen-2, IL-10 and PAF were 4 h after surgery. The sensitivity, specificity and accuracy of combined detection were 95.0%, 91.7% and 85.0%, respectively, which all higher than indicators single detection. Conclusion Serum amylase, trypsinogen-2, IL-10 and PAF levels individual detection has clinical signifi-cance in PEP disease, and the combined detection of serum amylase, trypsinogen-2, IL-10 and PAF levels can improve the early diagnostic value of PEP.%目的：探讨血清淀粉酶、胰蛋白酶原－2、白介素－10（interleukin－10， IL－10）和血小板活化因子（platelet activating factor， PAF）在经内镜逆行性胰胆管造影术（endoscopic retrograde cholangiopan-creatography， ERCP）术后胰腺炎（post－ERCP pancreatitis， PEP）患者中的表达及其联合检测在PEP中的诊断价值。方法收集我院2012年8月至2013年11月的ERCP患者120例，分为对照组（60例）和PEP组（60例），采用强生Vitros－350全自动干化学生化分析仪检测所有患者术前、术后4 h及术后24 h血清淀粉酶、胰蛋白酶原－2、IL－10和PAF水平，并对结果进行统计学分析。结果 PEP患者术后4 h和术后24 h血清淀粉酶、胰蛋白酶原－2、IL－10和PAF水平均显著高于术前及对照组术后4 h和术后24 h，差异均有统计学意义（P均＜0.05）。 PEP组患者血清淀粉酶水平在术后24 h最高，胰蛋白酶原－2、IL－10和PAF水平均为术后4 h最高。4项指标联合检测的灵敏度、特异性和准确度分别为95.0％、91.7％和85.0％，均高于各项指标单独检测。结论血清淀粉酶、胰蛋白酶原－2、IL－10和PAF水平单项检测均可用于PEP的诊断，联合检测可提高对PEP的诊断价值。