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目的淀粉酶、脂肪酶、胃液分泌型免疫球蛋白(SIg A)对急性胃肠损伤的诊断价值。方法选取2015年10月—2016年3月梧州市红十字会医院收治的急性胃肠损伤患者91例,根据疾病类型分为AGI组44例和非AGI组47例。比较两组患者血淀粉酶、脂肪酶、胃液SIg A指标,并通过ROC曲线评价淀粉酶、脂肪酶、胃液SIg A指标对急性胃肠损伤的诊断价值。结果 AGI组血清淀粉酶、脂肪酶水平高于非AGI组,胃液SIg A水平低于非AGI组,差异有统计学意义(P<0.05)。血清淀粉酶>150U/L诊断AGI的灵敏度为59.1%、特异度为80.9%,ROC曲线下面积为0.719,95%CI(0.615,0.808),具中等诊断价值;血清脂肪酶>88U/L诊断AGI的灵敏度为52.3%、特异度为91.5%,ROC曲线下面积为0.718,95%CI(0.614,0.808),具中等诊断价值;胃液SIg A<2.8g/L诊断AGI的灵敏度为90.9%、特异度为31.9%,ROC曲线下面积为0.626,95%CI(0.519,0.725),诊断价值较低。结论淀粉酶、脂肪酶,胃液SIg A对重症患者急性胃肠损伤有一定的诊断价值。
Objective To investigate the diagnostic value of amylase, lipase and secretory immunoglobulin of gastric juice (SIg A) in acute gastrointestinal injury. Methods 91 patients with acute gastrointestinal injuries admitted to Wuzhou Red Cross Hospital from October 2015 to March 2016 were divided into two groups: 44 patients in AGI group and 47 patients in non-AGI group according to the type of disease. The serum amylase, lipase and gastric juice SIg A index were compared between the two groups. The diagnostic value of amylase, lipase and gastric juice SIg A index in acute gastrointestinal injury was evaluated by ROC curve. Results The levels of serum amylase and lipase in AGI group were significantly higher than those in non-AGI group, while the level of SIg A in gastric juice was lower than that in non-AGI group (P <0.05). Serum amylase> 150U / L had a sensitivity of 59.1%, a specificity of 80.9%, and an area under the ROC curve of 0.719, 95% CI (0.615, 0.808) with moderate diagnostic value; serum lipase> 88U / L The sensitivity and specificity of AGI were 52.3% and 91.5%, respectively. The area under the ROC curve was 0.718 and 95% CI (0.614 and 0.808), respectively, with moderate diagnostic value. The AGI sensitivity of AGI was 90.9% The specificity was 31.9%. The area under the ROC curve was 0.626, 95% CI (0.519, 0.725), with lower diagnostic value. Conclusion Amylase, lipase and gastric juice SIg A have certain diagnostic value in acute gastrointestinal injury in critically ill patients.