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Predictive value of early measurement of serum procalcitonin and C-reactive protein for infectious pancreatic necrosis
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摘要:
目的探讨早期血清炎性介质对重症急性胰腺炎（SAP）继发后期感染性胰腺坏死的预测价值。方法回顾性分析兴义市人民医院2012年1月-2017年1月收治的166例患者临床资料。根据是否继发感染性胰腺坏死,分为感染组（58例）和未感染组（108例）,比较2组患者血清炎性介质水平,选取有统计学意义指标进一步行受试者工作特征曲线（ROC曲线）分析。计量资料组间比较采用独立样本t验,计数资料组间比较采用χ2检验。结果 166例SAP患者中58例继发感染性胰腺坏死,发生率为34.9%。感染组血清脂肪酶、PCT、CRP及APACHEⅡ评分明显高于未感染组（t值分别为8.679、20.416、18.429、8.563,P值均<0.05）。血清脂肪酶、PCT、CRP及APACHEⅡ评分对应的ROC曲线下面积分别为:0.647、0.877、0.823、0.655,诊断准确度最高的临界值分别为:612.5 U/L、7.5 ng/ml、226.5 mg/L、16.5分,灵敏度分别为:68.5%、91.2%、86.8%和60.5%,特异度分别为:59.3%、83.6%、80.1%和68....
Abstract:Objective To investigate the predictive value of early measurement of serum inflammatory mediators for infectious pancreatic necrosis secondary to severe acute pancreatitis (SAP) .Methods A retrospective analysis was performed for the clinical data of 166 patients who were admitted to our hospital from January 2012 to January 2017.According to the presence or absence of secondary infectious pancreatic necrosis, the patients were divided into infection group with 58 patients and non-infection group with 108 patients.The serum levels of inflammatory factors were compared between the two groups.The receiver operating characteristic (ROC) curve was used for the analysis of indices with statistical significance.The independent samples t-test was used for comparison of continuous data between groups, and the chi-square test was used for comparison of categorical data between groups.Results Of all 166 SAP patients, 58 experienced secondary infectious pancreatic necrosis, resulting in an incidence rate of 34.9%.Compared with the non-infection group, the infection group had significantly higher serum lipase, procalcitonin (PCT) , C-reactive protein (CRP) , and APACHE II score (t = 8.679, 20.416, 18.429, and 8.563, all P < 0.05) .The ROC curve analysis showed that serum lipase, PCT, CRP, and APACHE II score had areas under the ROC curve of 0.647, 0.877, 0.823, and 0.655, respectively, with cut-off values of 612.5 U/L, 7.5 ng/ml, 226.5 mg/L, and 16.5 points, sensitivities of 68.5%, 91.2%, 86.8%, and 60.5%, and specificities of 59.3%, 83.6%, 80.1%, and 68.7%, respectively.Conclusion The abnormally elevated serum levels of CRP and PCT have a certain predictive value for infectious pancreatic necrosis secondary to SAP with convenient and fast operation, and therefore, it holds promise for clinical application.
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Key words:
- pancreatitis, acute necrotizing /
- C-reactive protein /
- procalcitonin /
- early diagnosis
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