目的 探讨联合检测血清钙和C反应蛋白(CRP)对急性胰腺炎(AP)严重程度的早期预测价值.方法 回顾分析我院52例轻型急性胰腺炎(MAP)和21例重症急性胰腺炎(SAP)患者发病早期血清钙和C反应蛋白的变化规律,并对这两项指标预测SAP的诊断价值进行评估.结果 入院第一天,AP病人血清CRP水平即明显增高,第二天达高峰,SAP组比MAP组增幅更为显著(P＜0.001)；此时CRP诊断SAP的灵敏度、特异度和ROC曲线下面积分别为85.7％、94.2％、0.904.与正常对照组比较,MAP组患者血清钙无明显变化P＞0.05),而SAP组患者入院第1天血清钙水平即显著降低(P＜0.01),随着时间推移,血清钙水平继续下降；血清钙诊断SAP的灵敏度、特异度和ROC曲线下面积分别为76.2％、96.1％,0.874.联合检测血清钙和CRP诊断SAP的灵敏度、特异度和诊断指数分别为95.2％,92.3％,1.88.结论 血清钙和CRP联合检测对急性胰腺炎的危重程度有可靠的预测价值.%Objective To investigate the early predictive values of the combined detection of serum calcium and C-reaction protein (CRP) in the severity of acute pancreatitis (AP). Methods The serum calcium and C-reaction protein were monitored on days 1,2,3 and 4 in 52 patients with mild acute pancreatitis ( MAP) and 21 patients with severe acute pancreatitis ( SAP). Furthermore, the diagnostic sensitivity, specificity and area under curve ( AUC) of "them were also observed. Results The levels of serum CRP increased significantly in AP at the the first day of admission. But the levels of serum CRP were higher in SAP than those in MAP (P<0. 001). The diagnostic sensitivity of CRP was 85.7% , specificity 94.2% , AUC 0.904. Compared with the normal control group, the levels of serum calcium in SAP decreased notablely at the the first day of admission( P <0. 01) . But no significant difference was found between the MAP and normal control group ( P > 0. 05 ). The diagnostic sensitivity of serum calcium was 76. 2% , specificity 96. 1% ,AUC 0. 874. The diagnostic sensitivity of the combined detection was 95. 2% ,specificity 92. 3% ,diagnostic index 1. 88. Conclusions The combined detection of serum calcium and CRP can predict reliably the severity of acute pancreatitis.
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