C―反应蛋白与前白蛋白比值预测急性胰腺炎严重程度意义.docVIP

C―反应蛋白与前白蛋白比值预测急性胰腺炎严重程度意义 　　【摘要】 目的：探讨血清C-反应蛋白（CRP）与前白蛋白（PA）比值对急性胰腺炎（SAP）严重程度的预测价值。方法：选择2015年2月-2016年10月湖南省南华大学附属南华医院收治的48例急性胰腺炎患者，根据重度重症急性胰腺炎（SAP）的诊断标准将其分为SAP组16例及非SAP组32例。比较两组患者CRP、PA、CRP/PA比值水平，并利用工作特征曲线（ROC曲线）评估CRP、PA、CRP/PA比值对急性胰腺炎严重程度的预测价值。结果：SAP组中的CRP、PA、CRP/PA比值分别为（159.11±39.45）mg/L、（172.61±35.59）mg/L、（0.99±0.43），非SAP组分别为（113.30±24.75）mg/L、（219.43±35.54）mg/L、（0.55±0.26），提示SAP组中的CRP及CRP/PA比值明显高于非SAP组，SAP组的PA水平明显低于非SAP组，两组比较差异均有统计学意义（P0.05）。ROC曲线分析CRP、PA、CRP/PA预测SAP的AUC值分别为0.843、0.818、0.887，提示CRP、PA及CRP/PA均能很好地预测SAP（P0.05）。且CRP/PA的AUC大于CRP、PA的AUC。结论：急性胰腺炎患者血清高CRP、低PA、高CRP/PA均可提示SAP的发生，CRP/PA预测SAP具有更好的临床意义。 　　【关键词】 C-反应蛋白； 前白蛋白； 重度重症急性胰腺炎； 严重程度； 预测 　　【Abstract】 Objective：To explore the prognosis value of C-reactive protein （CRP） and pre-albumin （PA） ratio in the evaluation of severity degree of acute pancreatitis. Method：48 cases with acute pancreatitis （AP） patients in our hospital from February 2015 to October 2016 were selected.According to the diagnosis standard of severe acute pancreatitis（SAP），all of the 48 patients were divided into SAP group of 16 cases and non-SAP group of 32 cases.The levels of CRP，PA and CRP/PA of two groups were compared at the first 24 h.The receiver operating characteristic curve（ROC curve） was described to evaluate the predictive value of CRP、PA、CRP/PA ratio for SAP.Result：The data of CRP、PA、CRP/PA ratio in SAP group were （159.11±39.45） mg/L，（113.30±24.75） mg/L and （0.99±0.43） respectively，in non-SAP group of those respectively were（172.61±35.59）mg/L，（219.43±35.54）mg/L and （0.55±0.26），the PA level in SAP group was lower than that in non-SAP group，the levels of CRP and CRP/PA in SAP group were higher than non-SAP group，the differences were statistically significant（P0.05）.The ROC curve indicated that the area under the curve（AUC）of CRP，PA and CRP/PA ratio on the first day were 0.843，0.818，0.887 respectively，the characteristic of the data revealed that CRP，PA and CRP/PA ratio can predict SAP well（P0.05），and the AUC of CRP/PA r