摘要
目的探讨血浆降钙素原(PCT)、presepsin及D-二聚体(D-D)水平与急性胰腺炎(AP)患者预后转归的关系。方法我院诊治的120例AP患者,根据疾病严重程度分为轻症组(42例)、中度重症组(40例)和重症组(38例),入院后均给予内科治疗。另选取同期体检者49例为对照组,比较血浆PCT、presepsin和D-D水平。根据患者预后分为生存组和死亡组,比较两组入院后第1、3、7 d血浆PCT、presepsin和D-D水平,分析上述因子对预后的预测价值。结果轻中重症组血浆PCT、presepsin和D-D水平均高于对照组,重症组血浆PCT、presepsin和D-D水平高于轻症组和中度重症组(P<0.05);血浆PCT、presepsin和D-D水平均与疾病严重程度呈正相关(P<0.05);生存组第1、3、7 d的血浆PCT、presepsin和D-D水平均低于死亡组,且生存组第3、7 d血浆PCT、presepsin和D-D水平低于第1 d(P<0.05);三者联合的AUC最大,其中D-D诊断截断值1.83mg/L,敏感度为65.22%,特异度为90.72%;presepsin诊断截断值699.4 ng/L,敏感度为73.91%,特异度为82.47%;PCT诊断截断值3.36 ng/ml,诊断敏感度为78.26%,特异度为62.89%(P<0.05)。结论血浆PCT、presepsin和D-D水平与AP患者疾病严重程度呈正相关,且通过动态观察上述因子水平可较好的评估患者预后转归情况。
Objective To investigate the relationship between the levels of plasma procalcitonin(PCT),presepsin and D-dimer(D-D)and the prognosis of patients with acute pancreatitis(AP).Methods Clinical data of 120 patients with AP diagnosed and treated in our hospital were retrospectively analyzed.According to the severity of the disease,the patients were divided into mild group(n=42),moderate to severe group(n=40)and severe group(n=38).All patients received medical treatment after admission.Meanwhile,49 healthy individuals were selected as a control group.The levels of plasma PCT,presepsin and D-D were compared.According to the prognosis,the patients were divided into survival group and death group.The levels of plasma PCT,presepsin and D-D in the two groups on the 1 st and 7 th day after admission were compared,and the prognostic value of the above factors was analyzed.Results The levels of plasma PCT,presepsin and D-D in the patients with AP were significantly higher than those in the control group,and the above indexes in the severe group were significantly higher than those in the mild group and the moderate to severe group(P<0.05).The levels of plasma PCT,presepsin and D-D levels were positively correlated with the severity of the disease(P<0.05).The levels of plasma PCT,presepsinand D-D in the survival group on the 1 st,3 rd and 7 th days were significantly lower than those in the death group,and the levels in the survival group were significantly lower on the 3 rd and 7 th days than those on the 1 st day(P<0.05).The AUC of ROC curve analysis for the combination of the three indexes was the largest.The cut-off value,sensitivity and specificity for D-D were 1.83 mg/L,65.22%and 90.72%,respectively;for presepsin were 699.4 ng/L,73.91%and 82.47%,respectively and for PCT were 3.36 ng/ml,78.26%and 62.89%respectively(P<0.05).Conclusion The levels of plasma PCT,presepsin and D-D are positively correlated with the severity of AP.Dynamic observation of the levels of these factors can better assess the prognosis.
作者
付东
王浩宇
FU Dong;WANG Hao-yu(Department of Laboratory Medicine,Sichuan Baoshihua Hospital,Chengdu 610213,China)
出处
《实用医院临床杂志》
2021年第3期44-47,共4页
Practical Journal of Clinical Medicine
基金
成都市医学科研基金资助项目(编号:2019042)。
