【摘要】：目的探討血清降鈣素原(PCT)和可溶性髓樣細(xì)胞觸發(fā)受體-1(s TREM-1)對急性胰腺炎(AP)患者病情嚴(yán)重程度的預(yù)測價(jià)值。方法選取80例AP患者,其中輕癥急性胰腺炎患者38例(輕癥組)和重癥急性胰腺炎患者42例(重癥組);同期選取查體健康個(gè)體40例(對照組)。檢測AP患者入院第1、3及7天的s TREM-1和PCT濃度,并記錄血淀粉酶、血鈣、血糖及C-反應(yīng)蛋白濃度。同時(shí),進(jìn)行CT嚴(yán)重度指數(shù)(CTSI)評分、床旁急性胰腺炎嚴(yán)重度(BISAP)評分、急性生理與慢性健康狀況評分(APACHE II)。統(tǒng)計(jì)學(xué)分析AP患者入院第1、3及7天的s TREM-1和PCT濃度變化和ROC曲線下面積(AUC)判斷各觀察指標(biāo)對急性胰腺炎的診斷效能。結(jié)果 1重癥組的住院天數(shù)(14.94±7.23)vs(8.22±4.31)d、CTSI評分(5.64±2.55)vs(3.23±1.12)、BISAP評分(3.34±1.62)vs(1.41±0.73)、APACHE II評分(11.55±7.87)vs(6.42±4.21),明顯高于輕癥組,P0.05。2重癥組的s TREM-1[(0.46±0.28)vs(0.31±0.20),(0.21±0.16)ng/ml)]、PCT濃度[(4.62±1.67)vs(0.67±0.12),(0.10±0.01)ng/ml)],顯著高于輕癥組和對照組,P0.05;輕癥組的s TREM-1和PCT濃度顯著高于對照組,P0.05。3重癥組患者入院第1、3及7天的s TREM-1(0.46±0.28)vs(0.31±0.20);(0.40±0.17)vs(0.27±0.11);0.31±0.14)vs(0.25±0.09)ng/ml、PCT濃度(4.62±1.67)vs(0.67±0.12);(3.52±1.07)vs(0.49±0.10);(1.94±0.86)vs(0.31±0.09)ng/ml,均高于輕癥組,P0.05。而且兩組的s TREM-1和PCT濃度入院7 d內(nèi)均呈遞減趨勢。4對AP患者嚴(yán)重程度診斷效能較大的是PCT濃度(敏感度為96.8%,特異度為97.6%,AUC=0.972),其次是APACHE II評分(敏感度為90.4%,特異度為92.8%,AUC=0.916)和s TREM-1濃度(敏感度為88.1%,特異度為90.3%,AUC=0.892)。結(jié)論 AP患者s TREM-1和PCT濃度變化與AP的病情嚴(yán)重程度有關(guān),能夠預(yù)測AP的病情變化。
[Abstract]:Objective to investigate the value of serum procalcitonin (PCT) and soluble myeloid cell trigger receptor 1 (s TREM-1) in predicting the severity of (AP) in patients with acute pancreatitis. Methods A total of 80 patients with AP were selected, including 38 patients with mild acute pancreatitis (mild pancreatitis) and 42 patients with severe acute pancreatitis (severe group), and 40 healthy individuals (control group). S TREM-1 and PCT were measured on the 3rd and 7th day after admission, and serum amylase, calcium, blood glucose and C-reactive protein were recorded. At the same time, CT severity index (CTSI) score, bedside acute pancreatitis severity (BISAP) score, acute physiology and chronic health score (APACHE II).) were evaluated. The changes of s TREM-1 and PCT concentrations on the 3rd and 7th day after admission and the area under ROC curve (AUC) were analyzed statistically to evaluate the diagnostic efficacy of the observed indexes for acute pancreatitis. 緇撴灉 1閲嶇棁緇勭殑浣忛櫌澶╂暟(14.94鹵7.23)vs(8.22鹵4.31)d,CTSI璇勫垎(5.64鹵2.55)vs(3.23鹵1.12),BISAP璇勫垎(3.34鹵1.62)vs(1.41鹵0.73),APACHE II璇勫垎(11.55鹵7.87)vs(6.42鹵4.21),鏄庢樉楂樹簬杞葷棁緇，

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