摘要
目的探讨胆源性急性胰腺炎(biliogenic acute pancreatitis,BAP)患者凝血指标、D-二聚体(D-dimer,DD)和蛋白C水平变化情况,及其预测疾病严重程度的价值。方法 BAP患者63例,根据疾病严重程度分为轻度BAP组39例和中度BAP组24例。检测2组血常规、肝肾功能、血糖和血脂水平及凝血指标、DD和蛋白C水平。结果中度BAP组凝血酶原时间[(12.36±1.12)s]、凝血酶时间[(20.17±1.95)s]和DD[(3.18±1.97)mg/L)水平明显高于轻度BAP组[(11.67±0.89)s、(18.94±1.85)s和(1.08±0.76)mg/L],蛋白C水平[(70.02±13.12)%]明显低于轻度BAP组[(83.13±19.42)%](P<0.05);DD>1.59mg/L时诊断BAP的AUC为0.888,灵敏度为83.3%,特异度为82.1%,阳性预测值为74.1%,阴性预测值为88.9%;蛋白C<88.05%时诊断BAP的AUC为0.711,灵敏度为100%,特异度为51.3%,阳性预测值为54.5%,阴性预测值为100%。结论随BAP病情加重,DD水平增高,蛋白C水平降低,DD和蛋白C均可作为早期预测BAP严重程度的灵敏指标。
Objective To investigate the changes and disease severity predictive value of coagulation indexes, D-dimer and protein C in patients with hiliogenic acute pancreatitis （BAP）. Methods Sixty-three BAP patients were divided into mild BAP group （n=39） and moderate BAP group （n=24） according to the disease severity. The blood routine indexes, liver and kidney function, plasma glucose, blood lipids, coagulation indexes, D-dimer and protein C were detected in two groups. Results Prothrombin time （（12.36±1.12） s）, thrombin time （（20.17±1.95） s, and D-dimer （（3.18±1.97） mg/L） were significantly higher, and protein C level （（70.02 ± 13.12） %） was significantly lower in moderate BAP group than those in mild BAP group （（11.67±0.89） s, （18.94±1.85） s, （1.08±0.76） mg/L, （83.13±19.42）%） （P〈 0.05）. AUC, sensitivity, specificity, positive predictive value and negative predictive value for BAP were 0. 888, 83.3%, 82.1%, 74.1% and 88.9% when D-dimer was 1.59 mg/L, and were 0. 711, 100%, 51.3%, 54.5% and 100% when protein C was 〈88.05%. Conclusion D-dimer increases and protein C decreases with the severity of BAP. Both D-dimer and protein C can be used as sensitive indexes for predicting the severity of BAP.
出处
《中华实用诊断与治疗杂志》
2016年第11期1103-1105,共3页
Journal of Chinese Practical Diagnosis and Therapy
基金
首都医科大学学生科研创新项目(XSKY2015170)
