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目的对急性胰腺炎(acute panceratitis,AP)的实验室诊断方法进行评价,以期得出最合理的诊断指标。方法正常人100名,AP患者112名,非AP患者61名。同时测定血、尿淀粉酶(AMY)、淀粉酶肌酐清除率(CAMY/CCr%)、尿胰蛋白酶原-2(Tbg-2)、血清样淀粉蛋白A(SAA)、C反应蛋白(CRP)。结果 112例AP患者中Tbg-2阳性108例、CAMY/CCr%阳性100例、血、尿AMY阳性分别91和80例、SAA和CRP阳性为66和64例;急性重症胰腺炎患者的SAA和CRP的(x±s)分别为(432±240.6)mg/L,(162.6±86.85)mg/L;急性轻型胰腺炎患者(x±s)分别为(204.7±95.8)mg/L,(103.2±65.21)mg/L,t值为9.4和4.3,P值均<0.01。诊断敏感性及特异性以Tbg-2的最高,其次为CAMY、CCR%,血、尿AMY相对较差,SAA、CRP最差。结论 bg-2为目前诊断AP最理想的指标,其敏感性和特异性优于其他指标;如果条件不具备的可选用CAMY/CCR%来提高诊断正确率;SAA和CRP检测对诊断急性胰腺炎的重发和病情变化方面,有重要的应用价值。
Objective To evaluate the laboratory diagnosis of acute panceratitis (AP) in order to obtain the most reasonable diagnostic criteria. Methods One hundred normal subjects, 112 AP patients and 61 non-AP patients. The levels of serum amylase (AMY), creatinine clearance (CAMY / CCr%), Tbg-2, SAA and CRP were measured at the same time. . Results Among 112 AP patients, Tbg-2 was positive in 108 cases and CAMY / CCr% was positive in 100 cases. Blood and urine AMY positive were 91 and 80 cases, SAA and CRP were 66 and 64 cases respectively. SAA and The mean ± SD of CRP were (432 ± 240.6) mg / L and (162.6 ± 86.85) mg / L, respectively. The mean ± SD of the patients with CRP were (204.7 ± 95.8) mg / ± 65.21) mg / L, t values were 9.4 and 4.3, P <0.01. The diagnostic sensitivity and specificity were highest in Tbg-2, followed by CAMY, CCR%, blood and urine AMY were relatively poor, SAA, CRP worst. Conclusion bg-2 is the most ideal indicator for the diagnosis of AP, its sensitivity and specificity is better than other indicators; CAMY / CCR% can be used to improve the accuracy of diagnosis if the conditions are not available; SAA and CRP can be effective in diagnosing acute pancreatitis The recurrence and changes in the condition, there is an important application value.