目的：探讨血清降钙素原（ PCT）在诊断早期急性胰腺炎（ acute pancreatitis，AP）及合并感染中的临床价值。方法165例发病12 h内入院的AP患者，其中轻型胰腺炎（ MAP组）114例，重型胰腺炎（ SAP组）51例；合并感染（感染组）34例，未合并感染（非感染组）131例。检测患者在入院时、入院后第3天、第7天PCT、C反应蛋白（CRP）、白细胞介素-6（IL-6）的变化情况。结果 SAP组患者各时点血清PCT水平明显高于MAP组（P＜0.05），而血清CRP水平、IL-6水平与MAP组比较差异无统计学意义。感染组血清PCT水平在入院时、第3天及第7天均高于非感染组（ P＜0.01），CRP和IL-6水平差异无统计学意义（P＞0.05）。结论血清PCT能够在早期反映急性胰腺炎患者的病情严重程度，并且能够反映AP患者是否合并感染，有助于早期判断疾病的严重程度和早期合理预防感染，对急性胰腺炎的早期综合治疗具有一定的临床指导价值。%Objective To evaluate the clinical value of serum procalcitonin( PCT) in early diagnosis of acute pancreatitis( AP) with infection.Methods We investigated 165 cases with acute pancreatitis.According to Ranson score standards, they were divided into moderate pancreatitis group(MAP group,114 cases)and severe pancreatitis group(SAP group,51 cases).According to whether there was a bacterial infection,they were divided into infected group(34 cases)and non-infected group(131 cases).All of the patients went to hospital within 12 hour of the disease onset.The level of serum PCT,C react protein(CRP)and interleukin-6(IL-6)were determined on the 1st,3rdand the 7thday after onset,respectively.Results Plasma levels of PCT of each time point in the SAP group were significantly higher than that in the MAP group( all P<0.05) ,while the levels of CRP and IL-6 showed no difference.The PCT levels of each time point were significantly higher in the infected group than that in the non-infected group(P<0.01).Again,no significant differences in levels of CRP and IL-6 were found between the two groups(P>0.05) .Conclusion Serum levels of PCT can not only reflect the serious of acute pancreatitis at the early stage, but also determine whether AP is combined with infection .Therefore,determination of serum PCT levels can be used to diagnose the severity of the disease and help the early prevention of infection,thus has an important clinical value.
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