摘要
目的通过动态检测急性胰腺炎(AP)患者外周血清C反应蛋白(CRP)、脂肪酶(LPS)、白细胞介素(IL)1β和细胞间黏附分子(ICAM)1的水平及变化,评价多种指标联合检测在AP临床诊断中的价值。方法收集2010年1月-2012年12月在中国医科大学附属第四医院进行治疗的AP患者86例,其中重症急性胰腺炎(SAP)患者39例,轻症急性胰腺炎(MAP)患者47例。于入院第1、3、5、7天分别采集患者血清,另选取12例同期健康体检者作为对照。采用ELISA法检测血清中CRP、IL-1β和ICAM-1水平,干片速率法测定血清LPS的浓度。计量资料组间比较采用t检验,计数资料组间比较采用χ2检验。结果 MAP组患者入院第1天的CRP、IL-1β和LPS水平明显高于对照组,差异均有统计学意义(t值分别为-74.126、-60.135、-364.153,P值均<0.001);SAP组患者入院第1天的CRP、ICAM-1、IL-1β、LPS水平均明显高于对照组,差异亦有统计学意义(t值分别为-121.355、-25.728、-89.422、-415.840,P值均<0.001);各检测指标浓度的峰值出现在入院第1天或第3天,且随着治疗时间的延长,浓度呈进行性下降;与MAP患者相比,SAP患者血清中CRP、LPS、IL-1β和ICAM-1水平均较高,差异均有统计学意义(P值均<0.05)。结论联合检测患者血清CRP、LPS、IL-1β和ICAM-1水平对于AP严重程度的早期判断具有一定的临床参考价值。
Objective To evaluate the value of combined determination of various indices in the clinical diagnosis of acute pancreatitis （AP） through dynamic measurements of the levels of peripheral serum C -reactive protein （CRP） , lipase （LPS） , interleukin- 1β （IL- 113）, and intercellular adhesion molecule 1 （ ICAM - 1 ）, as well as changes in their levels, in patients with AP. Methods A total of 86 patients with AP who were treated in Fourth Affiliated Hospital of China Medical University from January 2010 to December 2012 were selected, among whom there were 39 patients with severe acute panereatitis （SAP） and 47 patients with mild acute panereatitis （MAP）. Serum sam- ples were collected from these patients on days 1,3,5, and 7 of admission. Twelve healthy subjects were selected as controls. Enzyme - linked immunosorbent assay was applied to measure the levels of CRP, IL - 1β, and ICAM - 1, and the dry slides method was applied to measure the concentration of serum LPS. The t test andχ2 test were applied for comparison of continuous data and categorical data between groups, respectively. Results On day 1 of admission, the patients in MAP group had significantly higher levels of CRP, IL - 1β, and LPS than those in control group （ t = - 74. 126, - 60. 135, and - 364. 153, respectively; all P 〈 0. 001 ） ; on day 1 of admission, the patients in SAP group had significantly higher levels of CRP, ICAM - I, IL - 1 β, and LPS than those in control group （ t = - 121. 355, - 25. 728, - 89. 422, and - 415. 840, respectively ; all P 〈 0.001 ）. The peak concentration of each index appeared on day 1 or 3 of admission, and decreased progressively in the course of therapy. The patients in SAP group had significantly higher levels of serum CRP, LPS, IL - 1β, and ICAM - 1 than those in MAP group （ all P 〈 0. 05 ）. Conclusion Combined determination of serum CRP, LPS, IL - 1β, and ICAM - 1 levels has a certain clinical value in early identification of severity of AP.
出处
《临床肝胆病杂志》
CAS
2016年第1期131-134,共4页
Journal of Clinical Hepatology
关键词
胰腺炎
C反应蛋白质
脂肪酶
白细胞介素1Β
胞间黏附分子1
诊断
panereatitis
C- reactive protein
lipase
interleukin- l beta
intercellular adhesion molecule- 1
diagnosis
