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目的:探讨血浆presepsin水平早期评估急性胰腺炎(AP)患者病情严重程度的临床价值。方法:前瞻性选取2016年12月至2019年1月间温州医科大学附属第二医院收治的67例AP患者，根据CT严重指数(CTSI)分级、入院时是否合并器官功能不全及局部或全身并发症将患者分为轻症AP组(MAP组，36例)和中度重症AP＋重症AP组(MSAP＋SAP组，31例)，另选20名健康者为对照组。检测各组入院2 h内血浆presepsin、C反应蛋白(CRP)、前降钙素原(PCT)、白细胞计数(WBC)及血淀粉酶、血钙水平，并计算入院24 h内APACHEⅡ评分。绘制受试者工作特征曲线(ROC)，计算曲线下面积(AUC)，分别评估presepsin、CRP、PCT、WBC及血淀粉酶、血钙水平对预测AP患者病情严重程度的临床价值。结果:MAP组、MSAP＋SAP组、对照组血浆presepsin水平分别为(439.59±74.23)、(1097.82±93.15)、(97.31±21.57)ng/L。胆源性MAP组和MSAP＋SAP组血浆presepsin水平均显著高于其他病因组，高脂血症性MSAP＋SAP组血浆presepsin水平显著高于MAP组，差异均有统计学意义(n P值均<0.05)。血浆presepsin诊断MSAP＋SAP的AUC为0.873(95%n CI 0.734～0.922)，最佳临界值为951.94 ng/L，灵敏度为85.6%，优于PCT、CRP、WBC及血钙；特异度为76.2%，仅次于血钙的78.9%。n 结论:血浆presepsin水平可以作为早期评估AP患者病情严重程度的敏感指标，其特异度仅次于血钙。“,”Objective:To investigate the clinical value of plasma presepsin level in early severity evaluation for acute pancreatitis (AP) patients.Methods:The clinical data of 67 patients with AP admitted in Second Affiliated Hospital of Wenzhou Medical University from December 2016 to January 2019 were prospectively selected. The patients were divided into mild AP group (MAP, n n=36) and moderately severe and severe AP group (MSAP+ SAP, n n=31) according to CTSI and with or without organ dysfunction and local or systemic complications on admission. Another 20 healthy normal subjects were selected as the control group. Plasma presepsin, C-reactive protein (CRP), procalcitonin (PCT), white blood cell count (WBC), serum amylase and calcium levels were measured within 2 hours, and the APACHEⅡ score was calculated within 24 hours of admission. Receiver operating characteristic curves(ROC) were plotted and the area under the curve (AUC) was calculated to assess the clinical value of presepsin, CRP, PCT, WBC, serum amylase and calcium for predicting the severity of AP patients, respectively.n Results:The plasma presepsin level in MAP, MSAP+ SAP and control group was (439.59±74.23)ng/L, (1097.82±93.15)ng/L and (97.31±21.57)ng/L, respectively. Plasma presepsin level in MAP and MSAP+ SAP patients with biliary pancreatitis were obviously higher than those patients with other etiological factors, and plasma presepsin level in MSAP+ SAP patients with hyperlipidemia-associated pancreatitis was significantly higher than those in the MAP group, and the difference was statistically significant (n P<0.05). The AUC of plasma presepsin in the diagnosis of MSAP+ SAP was 0.873(95%n CI 0.734-0.922), which was greater than the AUC values of CRP, PCT, WBC and serum calcium; the optimal cut-off value was 951.94 ng/L; the diagnostic sensitivity was 85.6%, which was superior to CRP, PCT, WBC and serum calcium; and the specificity was 76.2%, which was second to 78.9% of serum calcium.n Conclusions:Plasma presepsin level can be used as a sensitive indicator for early severity evaluation of AP patients, with a specificity only second to serum calcium.