| 孟祥俭 刘忠鑫 黄永廷 冯曙中△ 陈娇.降钙素原与APACHEⅡ评分对急性胰腺炎病情严重程度及预后的评估价值[J].,2016,16(28):5539-5542 |
| 降钙素原与APACHEⅡ评分对急性胰腺炎病情严重程度及预后的评估价值 |
| Clinical value of Procalcitonin and APACHE II in the Evaluation of Severityand Prognosis of Patients with Acute Pancreatitis |
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| DOI： |
| 中文关键词: 降钙素原 急性生理学与慢性健康状况评分 急性胰腺炎 预后 |
| 英文关键词: Procalcitonin Acute Physiology and Chronic Health Evaluation score Acute pancreatitis Prognosis |
| 基金项目:国家自然科学基金项目（81300197） |
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| 中文摘要: |
| 目的：探讨血清降钙素原(PCT)与急性生理学与慢性健康状况评分(APACHE II)对急性胰腺炎(AP)患者病情严重程度及预后
的评估价值。方法：选取本院2012 年5 月-2015 年5 月收治的急性胰腺炎患者280 例为研究对象。根据急性胰腺炎患者病情严重
程度将其分为低危组(83 例)、中危组(102 例)和高危组(95 例)；按患者临床结局将其分为存活组(248 例)及死亡组(32 例)，采用酶
联免疫吸附法(ELISA)检测各组血清PCT水平同时记录APACHE II 评分情况，分别比较PCT水平的差异以及与APACHE II 评
分的相关性，评价血清PCT 及APACHEⅡ评分对急性胰腺炎患者病情严重程度及预后的评估价值。结果：低危组、中危组及高危
组间血清PCT 水平和APACHE II评分的差异具有统计学意义(P<0.05)。其中，高危组血清PCT水平和APACHE II 评分最高，中
危组次之，低危组最低(P<0.05)；死亡组PCT水平及APACHE II评分显著高于存活组(P<0.05)。相关性分析显示血清PCT 水平与
APACHE II评分呈正相关(r=0.64，P<0.01)。以PCT>2.13 ng/mL为评估急性胰腺炎患者预后不佳界限时，其敏感性和特异性分别
79.2 %和91.3 %；以APACHE II 评分>18.1 分为评估急性胰腺炎患者预后不佳界限时，其敏感性和特异性分别为82.7 %和90.1
%；两者指标串联评估敏感性及特异性分别为86.1 %和92.9 %，ROC曲线下面积为0.921(95 %CI 0.824~0.938)。结论：急性胰腺
炎患者血清PCT水平和APACHE II 评分具有较好的相关性，血清PCT水平越高，APACHEⅡ评分越高，患者病情越严重及预后
也越差，二者联合可作为预测急性胰腺炎患者病情严重程度及预后的敏感指标，具有较好的临床应用价值。 |
| 英文摘要: |
| Objective:To investigate the clinical value of serum procalcitonin (PCT) level and Acute Physiology and Chronic
Health Evaluation (APACHE II) in the evaluation of severity and prognosis of patients with acute pancreatitis (AP).Methods:A total of
280 patients with acute pancreatitis in our hospital from May 2012 to May 2015 were enrolled in the study. According to the severity of
the disease, these patients were divided into the low-risk group (83 cases), moderate-risk group (102 cases) and high-risk group (95
cases). According to clinical outcome, these patients were divided into the survival group (248 cases) and death group (32 cases). The
serum level of PCT were measured by enzyme linked immunosorbent assay (ELISA), and APACHE II score was analyzed. The
differences of serum PCT levels and APACHE II scores were compared and its correlation with APACHE II score were analyzed, and
their correlation with the severity and the prognosis of acute pancreatitis were also assessed.Results:The difference in serum PCT levels
and APACHE II scores among low-risk group, moderate-risk group and high-risk group was statistically significant, in which high-risk
group was the highest, followed by moderate-risk group, low-risk group was the lowest (P<0.05); Compared the survival group, the death
group had higher serumPCT levels and APACHE II score (P<0.05). The PCT level and APACHE II score were positive correlated (r=0.
64, P<0.01). With PCT>2.13 ng/mL considered as the boundary for poor prognosis of acute pancreatitis, the sensitivity was 79.2 %, the
specificity was 91.3 %; With APACHE II score>18.1 considered as the boundary for poor prognosis of acute pancreatitis, the sensitivity
was 82.7 %, the specificity was 90.1 %; The AUC was 0.921 (95 %CI 0.824~0.938), and the sensitivity was 86.1 %, specificity was 92.9
%when the two cutoff values were both achieved.Conclusion:The serum PCT levels and APACHE II score showed good correlation in
acute pancreatitis; When the serum PCT level was higher, APACHE II score was higher, and the prognosis was worse. Combination of
serumPCT level and APACHE II score could be used as effective predictors for evaluating the severity and prognosis of AP. |
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