高敏C反应蛋白在重症急性胰腺炎诊断及预后判断中的价值探讨(1)
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[摘要] 目的：动态监测重症急性胰腺炎(severe acute pancreatitis，SAP)患者血清高敏C反应蛋白(high-sensitivity C-reactive protein，hs-CRP)水平，探讨其对SAP的诊断、严重程度及预后评估的价值。方法：动态检测51例SAP患者入院第1、3、5、7、10、14天外周静脉血中hs-CRP水平，并与同期48例轻症急性胰腺炎(mild acute pancreatitis，MAP)患者作对照研究。结果：入院第1天MAP患者血清hs-CRP水平均高于正常值10倍以上，SAP患者hs-CRP水平均高于正常值30倍以上，SAP组患者在相应时间hs-CRP水平显著高于MAP组，其中10例死亡患者hs-CRP水平在入院后即维持在高水平，持续不降。MAP组与SAP组之间、死亡组与SAP组之间hs-CRP水平比较，差异有统计学意义(P<0.05或P<0.01)。结论：动态监测hs-CRP水平可作为SAP早期诊断、严重程度及预后判断的一个独立的评估指标，值得临床推广应用。
[关键词] C反应蛋白；重症急性胰腺炎；诊断；预后
[中图分类号] R576 [文献标识码] A [文章编号] 1673-7210(2011)12(b)-056-03
The value of high-sensitivity C-reactive protein in the diagnosis and prognosis of severe acute pancreatitis
XING Jun, FENG Qingqing, ZHOU Hu*, LI Chun′an, FAN Tuoying
Department of Gastroenterology, the 94th Hospital of PLA, Jiangxi Province, Nanchang 330002, China
[Abstract] Objective: To explore the value of high-sensitivity C-reactive protein in the diagnosis and prognosis of severe acute pancreatitis. Methods: hs-CRP was detected on 1, 3, 5, 7, 10 and 14 days after admission in 51 patients with SAP, and they were compared with that of 48 cases of MAP who were selected as control group. Results: Admission day 1 MAP patients' serum hs-CRP levels were 10 times more than normal, SAP patients with hs-CRP levels were 30 times higher than normal, hs-CRP levels of SAP group in the corresponding time were significantly higher than those in MAP, of which hs-CRP levels in 10 fatal patients after admission were maintained at high level. Between MAP and SAP group, between the death group and SAP group of hs-CRP levels, the differences were statistically significant (P<0.05 or P<0.01). Conclusion: Dynamic monitoring of hs-CRP levels can be used as an independent evaluation indicator of SAP early diagnosis, severity and prognosis, and it is worthy of clinical application.
[Key words] C-reactive protein; Severe acute pancreatitis; Diagnosis; Prognosis
重症急性胰腺炎(SAP)是一种由多因素诱发，累及多环节的疾病，病情来势凶猛，死亡率为20%~30%[1]，因而如何快速准确地诊断SAP及判断其预后从而进行积极的个体化治疗显得非常重要 ......
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