急性胰腺炎患者外周血α―MSHTNF―αPCT动态检测及临床意义.docVIP

急性胰腺炎患者外周血α―MSHTNF―αPCT动态检测及临床意义 　　DOI：10.3760/cma.j.issn.1671-0282.2015.04.021 　　作者单位：230601 合肥，安徽医科大学第二附属医院急诊外科 　　通信作者：项和平，Email：： xhping1968@ 　　【摘要】目的 探讨急性胰腺炎患者外周血α-MSH、TNF-α、PCT的动态变化及其对患者病情严重程度的评估价值。方法 选取安徽医科大学第二附属医院急诊外科2011年3月至2014年3月收治的急性胰腺炎患者68例，其中轻症组36例、重症组32例。所有患者取入院后第1、3、5、7天静脉血，采用酶联免疫吸附法测定α-MSH、TNF-α、PCT水平。结果 与轻症组对比，重症组患者血清α-MSH质量浓度较低（Plt;0.05），而血清TNF-α及PCT水平高于轻症组（Plt;0.05）;在病情严重度评估方面，α-MSH敏感度为82.35%、特异度为88.24%、准确性为87.5%; TNF-α敏感度为76.47%、特异度为82.35%、准确性为81.25%;PCT敏感度为70.59%、特异度为76.47%、准确性为75.00%;PCT+TNF-α+α-MSH敏感度为88.24%、特异度为94.12%、准确性为93.75%;PCT、TNF-α、α-MSH及三者联合的曲线下面积分别为0.690、0.696、0.768及0.885。结论 血清α-MSH、TNF-α、PCT含量监测在急性胰腺炎患者病情严重程度评估方面具有一定的临床价值，其中α-MSH在病情评估方面的敏感性、特异性及准确性均高于后两者，而且外周血α-MSH含量较低预示患者病情严重，预后不良;此外，三者联合检测在病情严重程度评估方面具有更高的临床价值。 　　【关键词】 α-黑色素细胞刺激素;肿瘤坏死因子-α ;降钙素原;急性胰腺炎 　　Clinical significance and changes on serum levels of α-MSH， TNF-α， PCT in patients with acute pancreatitis 　　Gao Ming， Xiang Heping， Zhang Changle，Fu Rui.Emergency Surgery of the Second Affiliated Hospital of Anhui Medical University，Hefei 230601，China 　　Corresponding author：Xiang Heping，Email： xhping1968@ 　　【Abstract】Objective To investigate the dynamic changes in peripheral blood of patients with acute pancreatitis α-MSH， TNF-α， PCTS and the value of the patient assessment of disease severity.Methods Emergency surgery in the Second Affiliated Hospital of Anhui Medical University from March 2011 to March 2014 were treated 68 cases of acute pancreatitis patients， 36 patients with mild， 32 cases of severe group. All patients were extracted 1，3，5，7 days after admission blood， and α-MSH was measured by enzyme-linked immunosorbent assay， the content of TNF-αand PCT. Results Compared with the mild group， the serum of patients with severe group of α-MSH concentrations were lower （P lt;0.05）， while serum TNF-α and PCT levels higher than the mild group （Plt;0.05）; in disease severity assessment， α-MSH sensitivity of 82.35% and a specificity of 88.24%， the accuracy was 87.5%， TNF-α