酒精性急性胰腺炎CRP浓度及EPIC评分特点与其严重性的关系

摘要

Objective To study the relationship of the c-reactive protein concentration and extra-pancreatic inflammation on computed tomography score of alcoholic acute pancreatitis (AAP) with the severity of acute pancreatitis.Methods The clinical data of 66 hospitalized patients from January to December 2010 were retrospectively analyzed.There were 24 patients in AAP group and they were all male.There were 42 patients in non-AAP group including 29 male and 13 female.The c-reactive protein concentration (hypersensitive CRP, hs-CRP) and extra-pancreatic inflammation on computed tomography (EPIC) score were measured in 24 hours after admission.Results There were more male in AAP group than that in non-AAP group ( 100％ vs 69.05％ ,P =0.0065).The mean age of AAP group was siglificantly higher than that of non-AAP group [(41.58 ± 8.30) years vs (49.86 ± 17.39) years, P ＜ 0.05].The hs-CRP concentration and EPIC score in AAP group were siglificantly higher than those in non-AAP group (54.19 mg/L ±25.31 mg/L vs 32.04 mg/L ± 17.66 mg/L, P ＜ 0.05 ;2.83 ± 1.52 vs 1.38 ± 1.45,P = 0.0003, respectively).There was siglificantly different about the rate of severe acute pancreatitis between AAP group and non-AAP group (45.83％ vs 9.52％ , P =0.0021 ).The hs-CRP concentration and EPIC.score of severe acute pancreatitis were siglificantly higher than those of mild acute pancreatitis in AAP group (63.88 mg/L ± 17.10 mg/L vs 45.18 mg/L ± 24.26 mg/L,P =0.0435; 4.18 ± 0.40 vs 1.69 ± 1.11 ,P ＜ 0.05, respectively).Conclusion The young and middle age male were the major patients in AAP.The rate of severe acute pancreatitis was higher in AAP.The hs-CRP concentration and EPIC score of AAP were siglificantly higher than those of non-AAP.The hs-CRP concentration and EPIC score were higher in severe acute pancreatitis than those in mild patients.CRP concentration and EPIC score can reflect the severity of acute pancreatitis, and they may be the markers of the severity of acute pancreatitis.%目的 探讨酒精性急性胰腺炎(AAP)的血清C-反应蛋白(CRP)浓度及胰腺外炎症CT评分(EPIC)评分特点与胰腺炎严重性的关系.方法 回顾性分析2010年1月~12月在我院住院的急性胰腺炎患者66例.AAP 24例,全为男性.非AAP 42例,男29例,女13例.患者入院24 h内进行血清hs-CRP浓度检测及腹部CT检查.结果 AAP组中男性明显较非AAP组多(100% vs 69.05%,P＝0.0065).AAP患者年龄较非AAP患者年龄轻(41.58岁±8.30岁 vs 49.86岁±17.39岁,P＜0.05),AAP患者血清hs-CRP浓度、EPIC评分均明显较非AAP患者高(54.19 mg/L±25.31 mg/L vs 32.04 mg/L±17.66 mg/L,P＜0.05;2.83±1.52 vs 1.38±1.45,P＝0.0003).AAP重症率为45.83%,非AAP重症率为9.52%,差异具有明显统计学意义(P＝0.0021).AAP患者中,重症患者的血清hs-CRP及EPIC评分均较轻症患者高,差异有统计学意义(63.88 mg/L±17.10 mg/L vs 45.95 mg/L±24.26 mg/L,P＝0.0435;4.18±0.40 vs 1.69±1.11,P＜0.05).结论 中青年男性是AAP的易感人群,AAP重症发生率较高,AAP患者血清hs-CRP浓度及EPIC均明显较非AAP患者高,而且AAP组中重症患者的血清hs-CRP浓度及EPIC评分明显较轻症的高.CRP浓度及EPIC评分能反映AAP严重性,可以作为AAP严重性判断的有效指标.