血清钙与CRP联合检查对AP严重程度的早期预测价值分析

摘要

Objective To investigate the predictive value of C-reactive protein(CRP)and serum calcium in the patients with acute pancreatitis(AP).Methods 85 cases of AP in our hospital from January to December 2013 were selected as the study subjects,in-cluding 40 cases of mild acute pancreatitis(MAP)and 45 cases of severe acute pancreatitis(SAP).40 cases of normal volunteers were selected as the control group.The levels of serum calcium and CRP were detected in the three groups by the automatic bio-chemical analyzer and turbidimetric immunoassay.Results The levels of serum calcium in the MAP and SAP groups was on the low side and significantly lower than that in the control group,but which in the MAP group were higher than that in the SAP group,the differences were statistically significant(P <0.05).The level of serum CRP in the MAP group and SAP group was high-er than that in the control group,and which in the SAP group was higher than that in the MAP group,the difference was statistical-ly significant(P <0.05).The level of serum calcium on the third after admission in the MAP and SAP groups was significantlyin-creased compared with the day of admission(P <0.05),but the levels of CRP in the MAP and SAP groups were significantly de-creased,the difference was statistically significant(P <0.05).The CRP detection was more in clinic,but the experiment indicating that simultaneous detection of serum CRP and calcium could significantly increase the accuracy,sensitivity and specificity of clinical judgement,the difference had statistical significance(P <0.05).Conclusion Serum calcium and CRP can be used as the predictive indexes for the condition progression and prognosis of acute pancreatitis and their joint examination can improve the sensitivity,spe-cificity and accuracy of the detection.%目的：探讨 C 反应蛋白（CRP）与血清钙在急性胰腺炎（AP）患者中的临床预测价值。方法选取该院2013年1～12月收治的85例 AP 患者为研究对象，其中轻症急性胰腺炎（MAP）40例，重症胰腺炎（SAP）45例，另选取40例健康体检者为对照组，采用自动化分析仪测定3组血清钙水平，采用免疫比浊测定3组 CRP 水平。结果入院当天，SAP 组及 MAP 组血清钙水平均偏低，且明显低于对照组，其中 MAP 组则高于 SAP 组，差异有统计学意义（P ＜0.05）。而 MAP 组及 SAP 组 CRP 水平则高于对照组，且 SAP 组则高于 MAP 组，差异有统计学意义（P ＜0.05）。MAP、SAP 组入院第3天后血清钙水平较入院当天显著提高，而 CRP 水平则显著下降，差异有统计学意义（P ＜0.05）。临床上较多检测 CRP 检测，但是实验表明如果检测 CRP 的同时检测血清钙使的临床判断的准确性、灵敏性、特异性显著较高，差异有统计学意义（P ＜0.05）。结论血清钙与 CRP 可作为急性胰腺炎病情进展及预后的预测指标，两者一起检查可提高检测灵敏性、特异性及准确性。