Objective To investigate clinical value of serum C-reactive protein( CRP),procalcitonin( PCT),and lipase in predicting severe acute pancreatitis( SAP) during pregnancy. Methods A retrospective analysis was performed for the clinical data of 126 pregnant women with acute pancreatitis( AP) who were treated in Nongken Sanya Hospital from January 2011 to January 2016. According to the severity of AP,the patients were divided into control group( pregnancy complicated by mild-to-moderate AP,71 patients) and observation group( pregnancy complicated by SAP,55 patients). The clinical features of AP in pregnancy were compared between the two groups. The laboratory markers including venous leukocyte count,hemoglobin,plasma albumin,blood amylase,CRP,PCT,and lipase were observed. The t-test was used for comparision of continuos data between groups,and the chi-square test was used for comparision of categorial data between groups,and the receiver operating characteristic( ROC) curves were plotted for statistically significant markers to assess their sensitivities and specificities. Results The observation group had significantly higher serum levels of lipase,PCT,and CRP than the control group( lipase: 857. 73 ± 158. 61 U / L vs 590. 19 ±138. 67 U / L,χ~2= 7. 689,P < 0. 01; PCT: 10. 07 ± 4. 55 ng / ml vs 5. 89 ± 2. 13 ng / ml,χ~2= 15. 492,P < 0. 01; CRP: 269. 93 ± 63. 61 mg / L vs 202. 64 ± 39. 58 mg / L,χ~2= 7. 500,P < 0. 01). According to the ROC curves,serum lipase,PCT,and CRP had areas under the ROC curve of 0. 920,0. 841,and 0. 832,respectively,with corresponding cut-off values of 712 U / L,7. 6 ng / ml,and 262. 0 mg / L,sensitivities of 87.9%,83. 5%,and 81. 3%,and specificities of 83. 2%,86. 1%,and 78. 9%,respectively. Conclusion Increased serum levels of lipase,PCT,and CRP have a great value in the diagnosis of SAP during pregnancy.
[1]SHEN Y,CUI NQ.Clinical observation of immunity in patients with secondary infection from severe acute pancreatitis[J].Inflamm Res,2012,61(7):743-748.
|
[2]NICHOLSON LJ.Acute pancreatitis:should we use antibiotics?[J].Curr Gastroenterol Rep,2011,13(4):336-343.
|
[3]ZHAO HY,ZHANG Q,WU YZ.High risk factors and prognosis of acute pancreatitis in pregnancy[J].J Med Postgraduates,2015,28(1):64-66.(in Chinese)赵昊云,张秦,吴元赭.妊娠合并急性胰腺炎的高危因素及预后评估[J].医学研究生学报,2015,28(1):64-66.
|
[4] Group of Pancreas Surgery,Chinese Society of Surgery,Chinese Medical Association.Guidelines for the management of acute pancreatitis(2014)[J].J Clin Hepatol,2015,31(1):17-20.(in Chinese)中华医学会外科学分会胰腺外科学组.急性胰腺炎诊治指南(2014)[J].临床肝胆病杂志,2015,31(1):17-20.
|
[5]XIAO BH,HUANG GW,LI YX,et al.Acute pancreatitis during pregnancy:a 20-year single-center experience of 52 cases[J].Chin J Gen Surg,2014,23(3):297-300.(in Chinese)肖炳华,黄耿文,李宜雄,等.妊娠期急性胰腺炎:单中心20年52例分析[J].中国普通外科杂志,2014,23(3):297-300.
|
[6] ZOU JY,LIN J,YI SF,et al.Comparison of BISAP,Ranson's,APACHEⅡand CTSI score in evaluating the severity of acute pancreatitis[J].Chin J Digest Surg,2014,13(1):39-43.(in Chinese)邹金艳,林军,易三凤,等.BISAP、Ranson's、APACHEⅡ和CTSI评分系统在急性胰腺炎评估中的价值[J].中华消化外科杂志,2014,13(1):39-43.
|
[7]LIU T,ZHAO G.Research progress on laboratory diagnosis of acute pancreatitis[J].Chin J Med Offic,2014,42(10):1070-1075.(in Chinese)刘婷,赵冠.急性胰腺炎实验室诊断的研究进展[J].临床军医杂志,2014,42(10):1070-1075.
|
[8]KIM BG,NOH MH,RYU CH,et al.A comparison of the BISAP score and serum procalcitonin for predicting the severity of acute pancreatitis[J].Korean J Intern Med,2013,28(3):322-329.
|
[9]ZHAO BQ,CHEN YQ,ZHENG MF.Former of calcitonin and whole body inflammatory response syndrome[J].Med Recapitulate,2004,10(2):74-75.(in Chinese)赵冰清,陈宇清,郑明芳.前降钙素与全身炎症反应综合征[J].医学综述,2004,10(2):74-75.
|
[10]HUANG HL,NIE X,CAI B,et al.Procalcitonin levels predict acute kidney injury and prognosis in acute pancreatitis:a prospective study[J].PLo S One,2013,8(12):e82250.
|
[11]ZHANG NN,GUO XZ,LI HY,et al.A Meta-analysis of blood purification in severe acute pancreatitis in Chinese clinical trials[J].Trauma and Crit Medicine,2014,2(1):42-47.(in Chinese)张宁宁,郭晓钟,李宏宇,等.血液净化治疗急性重症胰腺炎疗效Meta分析[J].创伤与急危重病医学,2014,2(1):42-47.
|
[12]PONGPRASOBCHAI S,JIANJAROONWONG V,CHARATCHAROENWITTHAYA P,et al.Erythrocyte sedimentation rate and C-reactive protein for the prediction of severity of acute pancreatitis[J].Pancreas,2010,39(8):1226-1230.
|
[13]CARDOSO FS,RICARDO LB,OLIVEIRA AM,et al.C-reactive protein prognostic accuracy in acute pancreatitis:timing of measurement and cutoff points[J].Eur J Gastroenterol Hepatol,2013,25(7):784-789.
|
[14]NISTAL M,ZOLTANI M,LOHSE AW,et al.Analysis of the power of common diagnostic tools in the management of acute pancreatitis[J].Gastroenterol Res Pract,2014,2014:438697.
|
[15]ZHANG FQ,LIN Y.Clinical features and prognosis analysis of patients with acute pancreatitis of different grades during pregnancy[J].Chin Gen Pract,2015,18(33):4122-4125.(in Chinese)张发钦,林燕.妊娠期不同分级急性胰腺炎患者的临床特点及预后分析[J].中国全科医学,2015,18(33):4122-4125.
|