摘要
目的探讨C反应蛋白（C-reactiveprotein，CRP）对内镜下乳头括约肌切开术（EST）术后胰腺炎的早期诊断。方法选择经B超、CT或MRI（MRCP）证实为胆管结石的病人42例。①所有病人将拟施行ERCP、EST及经内镜取石，分别于术前1h及术后6h、24h、48h抽取空腹静脉血，同时测定这4个时间点的淀粉酶、脂肪酶及CRP。②将EST术后病人分为EST术后胰腺炎组（（post-ESTpancreatits，PEP组）和EST术后非胰腺炎组（非PEP组），对两组的淀粉酶、脂肪酶及CRP进行比较。结果在入选EST术后病人中，PEP组有5例，非PEP组有37例。两组病人术前淀粉酶、脂肪酶和CRP经比较，差异均无统计学意义（P〉0．05）。在PEP组，与术前比较，淀粉酶从6h开始差异有统计学意义，脂肪酶从24h开始差异有统计学意义，CRP在6h时差异有统计学意义。在非PEP组，脂肪酶和CRP在6h、24h、48h这3个时间点与术前比较，差异均无统计学意义（P〉0．05）；淀粉酶在术后24h开始与术前比较，差异有统计学意义（P〈0．05）。结论CRP可与血清淀粉酶、脂肪酶联合测定，作为EST术后急性胰腺炎早期诊断的指标之一。
Objective To investigate the implication of C-reactive protein （CRP） in the early di- agnosis of post-ERCP pancreatitis. Methods Forty-two consecutive patients with biliary stone con- firmed by ultrasonography, CT or MRI （MRCP） were selected. In all patients undergoing ERCP, ser- um amylase, lipase and CRP in the samples obtained before and 6, 24 and 48 after ERCP were determined; （2） The post-ERCP patients were divied into two groups： postoperative-ERCP pancreatitis group （PEP）, and post-ERCP non-pancreatitis （non-PEP）. The serum amylase, lipase and CRP lev- els were compared between two groups. Results There were 5 cases in PEP group, and 37 cases in non-PEP group, respectively. There was no significant difference in serum amylase, lipase, and CRP before ERCP between two groups. In PEP group, amylase and CRP levels from 6th h after ERCP showed significant difference from those before operation, and lipase from 24th h. In non-PEP group, lipase and CRP levels at 6th h, 24th h, and 48th h after ERCP showed no significant difference from those before ERCP, but there was significant difference in amylase level before and 24 h after ERCP. Conclusion CRP can be used as one of the biochemical markers in the early diagnosis of post-ERCP pancreatitis.
出处
《腹部外科》
2012年第6期353-355,共3页
Journal of Abdominal Surgery
关键词
C反应蛋白质
胰胆管造影术
内镜逆行
手术后并发症
胰腺炎
预测
C-reactive protein
Cholangiopancreatography, endoscopic retrograde
Postoperativecomplications
Pancreatitis
Forecasting
