降钙素原和C反应蛋白在急性胰腺炎病情及预后评估中的应用价值

摘要

【目的】探讨降钙素原（Procalcitonin ，PCT ）和C反应蛋白（C reactive protein ，CRP）在急性胰腺炎（acute pancreatitis ，AP）病情及预后评估中的价值。【方法】选取AP患者86例，根据患者的病情严重程度分为三组：轻度急性胰腺炎（MAP）27例（MAP组），中度急性胰腺炎（MSAP）39例（MSAP组），重度急性胰腺炎（SAP）20例（SAP组）。比较三组患者急性生理与慢性健康评分（APACHE Ⅱ）、血清淀粉酶、PCT和CRP水平。【结果】与治疗前相比，三组患者治疗后APACHE Ⅱ评分、淀粉酶、PCT和CRP水平随时间依次降低，差异具有统计学意义（ P ＜0．05），且各组患者不同时段APACHE Ⅱ评分、淀粉酶、PCT 和CRP水平比较有统计学差异（ P＜0．05）；患者的疾病严重程度、APACHE Ⅱ评分、血清淀粉酶、PCT和CRP水平与患者预后具有明显的相关性（ P ＜0．05）。出院后随访6个月，MAP组无患者死亡，MSAP组死亡率2．56％（1／39）；SAP组死亡率35．00％（7／20），三组死亡率比较差异有统计学意义（ P ＜0．05）。【结论】PCT和CRP水平可反映AP患者的病情严重程度，二者检测简单、方便，在AP患者预后评估中有重要的应用价值。%[Objective] To explore the value of joint detection of procalcitonin (PCT ) and C‐reactive pro‐tein (CRP) in the diagnosis and prognosis of acute pancreatitis (AP) .[Methods] From January 2013 to June 2014 ,86 AP patients were recruited and divided into 3 groups according to the severity ,i .e .MAP (mild ,n=27) ,MSAP (mild‐severe ,n=39) and SAP (severe ,n=20) .The clinical features of three groups were com‐pared .The acute physiology & chronic health evaluation Ⅱ (APACHE Ⅱ ) score ,serum amylase ,PCT and CRP at different timepoints were compared among three groups .And the prognostic factors of AP were ana‐lyzed .[Results] After 6 months ,none died in MAP group ,1 patient (2 .56% ) died in MSAP group and 7 (35 .00% ) died in SAP group .And the differences had statistical significance ( P<0 .05) .Before treatment , gender ,blood lipid and age had no statistical difference among three groups ( P >0 .05) .Fasting plasma glu‐cose (FPG) and blood calcium of three groups had statistical difference ( P<0 .05) .Compared with pre‐treat‐ment ,the APACHE II score decreased ( P < 0 .05) and three groups at different timepoints had statistical differences( P<0 .05) .The serum amylase ,PCT and CRP at different timepoints had statistical differences a‐mong three groups( P <0 .05) .The severity of AP ,APACHE II score ,serum amylase ,PCT and CRP had significant prognostic correlations ( P <0 .05) .[Conclusion] PCT and CRP can reflect the severity of AP . And a joint detection of PCT and CRP may be used for its prognostic evaluations .