血清CRP, PCT, 脂肪酶与胰腺炎分型及预后的相关性研究

目的:探讨血清CRP、PCT和脂肪酶和胰腺炎分型及预后的相关性。方法:87例急性胰腺炎患者,其中轻型急性胰腺炎65例,重症急性胰腺炎22例。在入院后1 d、3 d、7 d、14 d测定血清CRP、PCT、脂肪酶水平并进行APACHEⅡ评分。对比分析两组患者间不同时间点CRP、PCT、脂肪酶及APACHEⅡ评分差异,采用多元线性回归分析影响胰腺炎预后的影响因素。结果:胰腺炎发病严重程度和糖尿病、饮酒史、胆源性结石病有一定的相关性(P0.05)。轻型组CRP、PCT水平1 d、3 d水平和重型组无统计学差异(p0.05);7 d及14 d差异有统计学意义(P0.05)。轻型组脂肪酶水平和重型组3 d、7 d及14 d差异有统计学意义(P0.05)。轻型组APACHEⅡ评分和重型组相比,在发病后1 d、3 d、7 d及14 d差异有统计学意义(p0.05)。回归方程:Logit P=0.0017×PCT+0.0297×胆源性结石病史+0.093×APACHEⅡ评分-0.193。结论:糖尿病和胆源性结石和重症胰腺炎相关,PCT、APACHEⅡ持续不下降提示胰腺炎预后不佳。

orrelation of Serum CRP, PCT and Lipase Levels with its Pancreatitis Classification and Prognosis

ABSTRACT Objective: To investigate the correlation of serum CRP, PCT and lipase levels with the classification and prognosis of pancreatitis. Methods: 87 cases of patients with acute pancreatitis, including, 65 cases of light acute pancreatitis, and 22 cases of severe acute pancreatitis. At 1 d, 3 d, 7 d, 14 d after admission, the levels of serum CRP, PCT and lipase were detected, and the APACHEII scores were calculated. Compare and analyze the differences of CRP and PCT, lipase and APACHEII score at different time points between the two groups. Multiple linear regression was applied to analyze the risk factors of the prognosis of acute pancreatitis. Results: The severe degree of acute pancreatitis had a correlation with diabetes, history of drinking and gallstone lithiasis (P<0.05). The CRP and PCT level at 1 d, 3 d had no statistical difference between light group and severe group (P>0.05), but at 7 d and 14 d, they were statistically different between the two groups (P<0.05). The lipase levels at 3 d, 7 d and 14 d also had statistical difference between the two groups (P<0.05). The APACH EII score also statistically significant difference at 1 d, 3 d, 7 d and 14 d (P<0.05). Regression equation: Logit P=0.0017×PCT +0.0297×history of gallstone calculi + 0.093×APACHEII score-0.193. Conclusion: The diabetes and gallstone calculi were associated with severe acute pancreatitis. PCT level and APACHEII scores keeping in a high level indicated a poor prognosis of acute pancreatitis.