血清Ghrelin及胸腔积液变化对急性胰腺炎患者病情的评估价值

摘要

目的：探究血清Ghrelin及胸腔积液变化对急性胰腺炎患者病情的评估价值。方法选取2011年2月至2014年2月该院收治的急性胰腺炎患者80例，根据患者病情的轻重将患者分为轻症组（31例）和重症组（49例），所有患者均抽取入院时、入院后48h和出院当日清晨空腹情况下的静脉血，检测患者C反应蛋白（CRP）、白细胞（WBC）、降钙素原（PCT）水平；采用酶联免疫吸附法测定患者血清Ghrelin的水平；拍胸片确诊患者胸腔积液。结果与轻症组比较，重症组患者血清Ghrelin、CRP水平、APACHE评分、CT评分、Ranson评分较高，住院天数较长（P＜0．01）；CRP、胸腔积液、血清Ghrelin、血清Ghrelin联合胸腔积液的曲线下面积分别为0．7083、0．7496、0．8524、0．9108。血清Ghrelin联合胸腔积液对急性胰腺炎患者病情的评估价值最高。CRP敏感性为93．6％、特异性为69．4％、准确性为73．7％；胸腔积液敏感性为75．2％、特异性为88．7％、准确性为76．8％；Ghre‐lin敏感性为86．9％、特异性为88．2％、准确性为85．3％；血清Ghrelin联合胸腔积液敏感性为90．1％、特异性为92．6％、准确性为91．4％。结论血清Ghrelin联合胸腔积液变化对急性胰腺炎患者病情评估的敏感度、特异性和准确性较高，具有较高的临床价值。%Objective To explore the evaluation value of serum Ghrelin and pleural effusion in patients with acute pancreatitis . Methods Eighty patients with acute pancreatitis treated in our hospital from February 2011 to February 2014 were divided into mild case group (31 patients) and severe case group (49 patients) according to the severity of the disease .Venous blood samples were collected at time point including :admission ,48h after admission and after discharge at empty stomach in the morning ,and CRP level ,WBC ,PCT level of patients were checked .The concentration of serum Ghrelin of patients were mensurated by enzyme linked immunosorbent assay and pleural effusion were diagnosed by sternum .Results Compared with the patients in the mild case group , serum Ghrelin ,CRP level ,APACHE score ,CT score and Ranson score were higher in the severe case group and the hospital day of patients in the severe case group was longer(P<0 .01) .The area under the curve of CRP level ,pleural effusion ,Ghrelin ,Ghrelin combined with pleural effusion of ROC were 0 .708 3 ,0 .749 6 ,0 .852 4 and 0 .910 8 .Ghrelin combined with pleural effusion has the best evaluation effect on the patients with acute pancreatitis .The sensibility ,specificity ,accuracy of CRP were 93 .6% ,69 .4% and 73 .7% ;the sensibility ,specificity ,accuracy of pleural effusion were 75 .2% ,88 .7% and 76 .8% ;the sensibility ,specificity ,accuracy of Ghrelin were 86 .9% ,88 .2% and 85 .3% ;the sensibility ,specificity ,accuracy of Ghrelin combined with pleural effusion were 90 .1% ,92 .6% and 91 .4% .Conclusion Serum Ghrelin and pleural effusion have high sensibility ,specificity and accuracy in pa‐tients with acute pancreatitis and has high clinical value .