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目的探讨胰蛋白酶原激活肽(TAP)对重症急性胰腺炎的早期诊断价值,并观察TAP与重症急性胰腺炎患者预后的关系。方法收集胰腺炎患者89例,其中重症急性胰腺炎患者45例,轻症急性胰腺炎患者44例,32例排除胰腺炎的急腹症患者作为对照组;所有患者在入院6 h内采集血液使用ELISA试剂盒检查TAP值,同时观察胰腺炎患者中出现并发症的例数;采用ROC曲线分析TAP对胰腺炎的诊断价值,同时分析对轻症急性胰腺炎及其并发症的判别价值。结果 3组患者的TAP值比较差异有统计学意义(P<0.01),以重症急性胰腺炎患者值最大;ROC曲线分析显示,以TAP值2.78 nmol/L作为判别标准,TAP诊断胰腺炎的灵敏度为88.8%、特异性为100%、准确性为91.7%;以TAP值8.55 nmol/L作为判别轻症与重症急性胰腺炎,灵敏度为92.9%、特异性为95.2%、准确性为88.7%;以TAP值11.20 nmol/L作为并发症的判别,灵敏度为75.0%、特异性为90.4%、准确性为82.2%。结论 TAP在早期可用于诊断胰腺炎,尤其对诊断重症急性胰腺炎具有重要的价值,同时TAP还可用于评价重症急性胰腺炎患者的预后。
Objective To investigate the early diagnostic value of trypsinogen-activated peptide (TAP) in severe acute pancreatitis and observe the relationship between TAP and the prognosis of severe acute pancreatitis. Methods 89 cases of pancreatitis were collected, including 45 cases of severe acute pancreatitis, 44 cases of mild acute pancreatitis, 32 cases of acute abdomen patients with pancreatitis excluded as control group; all patients within 6 h after admission blood collection ELISA kit was used to examine the TAP value and observe the number of complications in patients with pancreatitis. The ROC curve was used to analyze the diagnostic value of TAP in pancreatitis. Meanwhile, the discriminant value of the TAP value in the diagnosis of mild acute pancreatitis and its complications was analyzed. Results The TAP values of the three groups were significantly different (P <0.01), and the patients with severe acute pancreatitis had the highest value. The ROC curve analysis showed that the TAP value of 2.78 nmol / L was the diagnostic criterion for the diagnosis of pancreatitis The specificity and specificity were 88.8%, 100% and 91.7% respectively. The sensitivity and specificity of TAP value 8.55 nmol / L were 92.9%, 95.2% and 88.7%, respectively. TAP value of 11.20 nmol / L as a complication of discrimination, sensitivity was 75.0%, specificity was 90.4%, accuracy was 82.2%. Conclusion TAP can be used in the early diagnosis of pancreatitis, especially for the diagnosis of severe acute pancreatitis has an important value, while TAP can be used to evaluate the prognosis of patients with severe acute pancreatitis.