目的揭示急性胰腺炎（ａｃｕｔｅｐａｎｃｒｅａｔｉｔｉｓ，ＡＰ）时有关反映细胞外间质变化的血清学指标如透明质酸（ｈｙａｌｕｒｏｎｉｃａｃｉｄ，ＨＡ）、Ⅲ型前胶原肽（ＰⅢＰ）、Ⅳ型前胶原肽（ＰⅣＰ）及板层素（ｌａｍｉｎｉｎ，ＬＮ）等的变化规律及其意义．方法急性轻型胰腺炎（ｍｉｌｄａｃｕｔｅｐａｎｃｒｅａｔｉｔｉｓ，ＭＡＰ，ｎ＝１０８），急性重型胰腺炎（ｓｅｖｅｒｅａｃｕｔｅｐａｎｃｒｅａｔｉｔｉｓ，ＳＡＰ，ｎ＝２６），进行血清ＨＡ，ＰⅢＰ，ＰⅣＰ及ＬＮ含量测定，按ＡＰＡＣＨＥ及Ｒａｎｓｏｎ标准计分统计．结果和正常组比较，ＭＡＰ组ＨＡ，ＰⅢＰ，ＰⅣＰ及ＬＮ的血清含量有所升高，但无统计学差异，但ＳＡＰ组的早期，这些指标异常升高，和ＭＡＰ组间差异显著（ＨＡ，ＰⅢＰ，Ｐ＜００１；ＬＮ，Ｐ＜００５），四例死亡者ＨＡ及ＰⅢＰ升高更加明显，ＨＡ＞２００μｇ／Ｌ，ＰⅢＰ＞１６０μｇ／Ｌ），单项血清ＨＡ及ＰⅢＰ对ＳＡＰ诊断率达７８７％和７３０％，低于ＡＰＡＣＨＥⅢ标准，但是高于Ｒａｎｓｏｎ１１—６标准，且假阳性率较低，低于１０％．结论血清ＨＡ及ＰⅢＰ等含量是ＳＡＰ早期诊断及预后判定的理想指标 Objective To reveal the changes of serum extracellular matrix in patients with acute pancreatitis (acute pancreatitis, AP) including serum hyaluronic acid (HA), type Ⅲ procollagen peptide (P Ⅲ P), type Ⅳ procollagen peptide (P Ⅳ P) Laminin (laminin, LN) and other changes and its significance. Methods The levels of serum HA, PⅢP, PⅣP and LN in patients with acute pancreatitis (MAP, n = 108) and severe acute pancreatitis (SAP, n = 26) were measured and scored according to APACHE and Ranson criteria. Results Compared with the normal group, serum levels of HA, PⅢP, PⅣP and LN in MAP group increased but there was no statistical difference. However, these indexes increased abnormally in the early SAP group and were significantly different from MAP group (HA, PⅢP, P <001; LN, P <005), HA and PⅢP increased more obviously in four deaths, HA> 200μg / L and PⅢP> 160μg / L) Rates were 78.7% and 73.0%, lower than the APACHE Ⅲ standard, but higher than the Ranson11-6 standard, and the false positive rate was low, less than 10%. Conclusion Serum HA and PⅢP levels are the ideal indicators for the early diagnosis and prognosis of SAP