本文選題：急性胰腺炎 + 慢性腎病　； 參考：《山西醫(yī)科大學》2017年碩士論文

【摘要】：目的:探討血淀粉酶對診斷慢性腎病患者合并急性胰腺炎時的價值和可靠性。方法:本研究采用的是回顧性調(diào)查分析,病例收集于山西醫(yī)科大學第一、第二附屬醫(yī)院及山西省人民醫(yī)院。病例納入標準:慢性腎病史的急性胰腺炎患者,就診時合并腹痛或腹部不適的普通慢性腎病患者,以及不合并慢性腎病的急性胰腺炎患者,所有病例入院后均行腹部超聲或腹部CT檢查確診或排除急性胰腺炎診斷,慢性腎病患者在本次入院前已獲得臨床診斷。依次分為CKD+AP組、CKD組、AP組。收集各組病人的一般資料及臨床資料,在各組之間進行統(tǒng)計學分析。結果:在CKD+AP組和AP組比較中,兩組血淀粉酶水平分別為655.7±414.3和621.1±299.4,診斷的敏感性分別為77.8%和85.7%,兩組數(shù)據(jù)差別無統(tǒng)計學意義。CKD組的血淀粉酶為246.0±116.4,與CKD+AP組相比存在統(tǒng)計學差異,結合兩組數(shù)據(jù),血淀粉酶診斷的特異性為81.6%。將高于參考值4倍作為診斷標準,血淀粉酶的特異性可升高到93.9%,但敏感性則下降到61.1%,漏診率為38.9%。比較CKD組患者AMY與CREA的相關性,相關系數(shù)為0.769,存在顯著的正相關。結論:血淀粉酶對診斷慢性腎病合并急性胰腺炎的價值有限,尤其是腎功能損害較為嚴重、血清肌酐水平較高的患者。
[Abstract]:Objective: to investigate the value and reliability of serum amylase in the diagnosis of chronic nephropathy complicated with acute pancreatitis. Methods: the cases were collected from the first and second affiliated hospitals of Shanxi Medical University and the people's Hospital of Shanxi Province. Inclusion criteria: patients with acute pancreatitis with a history of chronic nephropathy, patients with common chronic nephropathy with abdominal pain or abdominal discomfort at the time of treatment, and patients with acute pancreatitis without chronic nephropathy, The diagnosis of acute pancreatitis was confirmed or excluded by abdominal ultrasound or CT examination after admission, and the clinical diagnosis was obtained in patients with chronic nephropathy before admission. They were divided into CKD AP group and CKD group AP group in turn. The general and clinical data of patients in each group were collected and analyzed statistically. Results: the serum amylase levels of the two groups were 655.7 鹵414.3 and 621.1 鹵299.4, respectively. The diagnostic sensitivity was 77.8% and 85.7%, respectively. There was no significant difference between the two groups. The serum amylase levels in the CKD group were 246.0 鹵116.4, which were significantly different from those in the CKD AP group. Combined with two groups of data, the specificity of diagnosis of serum amylase was 81.6%. The specificity of serum amylase was increased to 93.9, but the sensitivity decreased to 61.1, and the missed diagnosis rate was 38.9. Compared the correlation between Amy and CREA in CKD group, the correlation coefficient was 0.769, there was significant positive correlation. Conclusion: serum amylase is of limited value in the diagnosis of chronic nephropathy complicated with acute pancreatitis, especially in patients with severe renal function damage and high serum creatinine level.
【學位授予單位】：山西醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R692;R576

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本文編號：2118599