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目的降钙素原(PCT)作为严重细菌感染的早期诊断指标,是反映机体感染程度的一个生物学指标,可对细菌感染进行预测判断。本研究通过检测血清降钙素原探讨其对急性胰腺炎(AP)严重程度的早期诊断价值。方法收集AP患者109例,其中重症急性胰腺炎(SAP)41例,轻型急性胰腺炎(MAP)68例,50例健康体检人群空腹血清PCT和CRP为对照,分别在入院后第1、3、5、7天动态监测患者PCT和CRP水平,分析这些指标与AP严重程度及预后关系,采用SPSS 17.0统计软件对数据进行处理。结果 MAP组和SAP组患者血清PCT和CRP水平均高于对照组(P<0.05),除第1天血清CRP外,其余SAP组患者同期PCT和CRP水平均高于MAP组(均P<0.05)。以2.0μg/L和120.0 mg/L分别为诊断SAP血清PCT和CRP阳性阈值,血清PCT和CRP诊断SAP的灵敏度分别为82.9%和70.7%,特异度均达90%以上,PCT和CRP联合检测则发现灵敏度提高到92.7%,而特异度仍达90%以上。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,有一定的临床指导价值。以2.0μg/L和120 mg/L分别为诊断SAP血清PCT和CRP阳性阈值,血清PCT诊断SAP具有很好的灵敏度和特异度。
Objective The expression of procalcitonin (PCT), as an early diagnostic indicator of severe bacterial infection, is a biological indicator reflecting the degree of infection in the body and can predict the bacterial infection. In this study, we examined the serum procalcitonin for early diagnosis of acute pancreatitis (AP) severity. Methods A total of 109 AP patients were collected, including 41 cases of severe acute pancreatitis (SAP), 68 cases of light acute pancreatitis (MAP) and 50 cases of healthy people. The fasting serum PCT and CRP were used as controls. The levels of PCT and CRP in patients were dynamically monitored on day 5 and 7, and the relationship between these indexes and the severity and prognosis of AP was analyzed. The data were processed by SPSS 17.0 statistical software. Results The levels of PCT and CRP in MAP group and SAP group were significantly higher than those in control group (P <0.05). Except for serum CRP on day 1, the levels of PCT and CRP in SAP group were significantly higher than those in MAP group (P <0.05) ). The diagnostic thresholds of PCT and CRP for SAP were 2.0μg / L and 120.0 mg / L, respectively. The sensitivity and specificity of PCT and CRP for diagnosis of SAP were 82.9% and 70.7%, respectively. The specificity of PCT was 90%. The PCT and CRP combined detection The sensitivity was found to increase to 92.7%, while the specificity was still above 90%. Conclusions Serum PCT can reflect the severity of the disease in patients with acute pancreatitis in the early stage and has certain clinical value. Using 2.0μg / L and 120mg / L as diagnostic thresholds for PCT and CRP in SAP, respectively, serum PCT has a good sensitivity and specificity for diagnosis of SAP.