摘要
目的探讨血清和肽素在亚特兰大新分类标准下预测急性胰腺炎(acute pancreatitis,AP)严重程度的价值研究。方法将兰州军区兰州总医院确诊的AP患者144例按照2012年亚特兰大分类标准分为轻度急性胰腺炎(mild acute pancreatitis,MAP)组52例、中度急性胰腺炎(moderately severe acute pancreatitis,MSAP)组55例、重度急性胰腺炎(severe acute pancreatitis,SAP)组37例,所有患者于入院1 d、7 d、14 d、出院当天清晨空腹静脉抽血3 ml,酶联免疫吸附法(ELISA)测定血清和肽素水平。结果 3组患者在年龄、红细胞压积(hematocrit,HCT)、性别、病因构成上差异无统计学意义(P>0.05),而随着疾病严重程度的增加,患者尿素氮(blood urea nitrogen,BUN)、肌酐、APACHE-Ⅱ评分均增加,差异有统计学意义(P<0.05);在患者入院1 d和7 d时,随着AP严重程度的增加,血清和肽素水平增加,差异有统计学意义(P<0.05),在患者入院14 d和出院时,随着AP严重程度的增加,血清和肽素水平无明显变化,差异无统计学意义(P>0.05);随着住院时间的增加直至出院,血清和肽素水平在MAP、MSAP、SAP组均明显降低,差异有统计学意义(P<0.05);和肽素、BUN、肌酐、APACHE-Ⅱ与AP严重程度呈正相关(P<0.05);在预测MAP、MSAP时,和肽素的AUC优于BUN、肌酐、APACHE-Ⅱ评分,差异有统计学意义(P<0.05),BUN、肌酐、APACHE-Ⅱ评分的AUC相近,差异无统计学意义(P>0.05);在预测SAP时,和肽素的AUC优于BUN、肌酐、APACHE-Ⅱ评分,差异有统计学意义(P<0.05),BUN、肌酐、APACHE-Ⅱ评分的AUC相近,差异无统计学意义(P>0.05)。结论血清和肽素水平与AP的严重程度密切相关,和肽素可作为预测AP严重程度的参考指标。
Objective To investigate the value of serum copeptin levels in predicting the severity of acute pancreatitis（ AP） under the new Atlanta classification criteria. Methods One hundred and forty-four Patients with AP in Lanzhou General Hospital were selected,and according to the 2012 classification standard of Atlanta,they were divided into MAP group of 52 cases,MSAP group of 55 cases and SAP group of 37 cases. Three ml venous blood were collected at 1 day,7 days,14 days of admission and discharged time. Serum copeptin level was detected by ELISA.Results The age,gender,hematocrit（ HCT） and causes had no significant difference among 3 groups（ P〈0. 05）.The blood urear nitrogen（ BUN）,serum creatinine,and APACHE-Ⅱ score were increased with the rise of disease severity,and the difference was statistically significant（ P〈0. 05）. The serum copeptin level of patients was increased with the rise of the severity of AP at 1 day and 7 days of admission,and the difference was statistically significant（ P〈0. 05）. The serum copeptin level of patients had no significant changes with the rise of the severity of AP at 7 days of admission and discharged time（ P〈0. 05）. The serum copeptin levels were significantly decreased with the increase of hospitalization time until discharged in MAP,MSAP and SAP group,and the difference was statistically significant（ P〈0. 05）. The peptide,BUN,creatinine and APACHE-Ⅱ score were positively correlated with the severity of AP（ P〈0. 05）. The AUC of copeptin in predicting MAP and MSAP was higher than that of BUN,creatinine and APACHE-Ⅱscore,and the difference was statistically significant（ P〈0. 05）. The AUC of APACHE-Ⅱ score,BUN and creatinine were similar,and the difference was not statistically significant（ P〈0. 05）. The AUC of copeptin in predicting of SAP was better than that of BUN,creatinine,APACHE-Ⅱ score,and the difference was statistically significant（ P〈0. 05）.The AUC of APACHE-Ⅱ score,BUN and creatinine were similar,and the difference was not statistically significant（ P〈0. 05）. Conclusion The serum copeptin levels are closely related to the severity of AP. The copeptin may serve as a reference marker for predicting the severity of AP.
作者
蒋立钊
刘石
JIANG Lizhao;LIU Shi(Department of Emergency Medicine,Lanzhou General Hospital of Lanzhou Military Command,Lanzhou 730000,China)
出处
《胃肠病学和肝病学杂志》
CAS
2018年第7期808-812,共5页
Chinese Journal of Gastroenterology and Hepatology
关键词
血清和肽素
亚特兰大新分类标准
急性胰腺炎
Serum copeptin levels
New Atlanta classification criteria
Acute pancreatitis
