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目的:探讨血液学指标在预测重症急性胰腺炎合并肺部感染的临床诊断价值。方法:选择2013年1月—2015年6月在本院接受治疗的重症急性胰腺炎患者作为研究对象,依据患者是否伴有肺部感染将患者分为非感染组及感染组。检测对比两组外周血TNF-α、IL-10、CRP及降钙素原水平。结果:本研究共纳入非感染组48例;感染组45例。感染组患者的TNF-α、CRP、降钙素原均高于非感染组患者,差异具有统计学意义(P<0.05)。ROC曲线分析显示,以21.44 ng/L为截点值,TNF-α诊断重症急性胰腺炎继发肺部感染的敏感性为80.00%,特异性为85.42%,曲线下面积为0.83;其结果优于CRP、降钙素原。结论:TNF-α、CRP、降钙素原是重症急性胰腺炎合并肺部感染中的诊断的可靠指标,其中TNF-α具有较高的特异性和敏感性,在预测重症急性胰腺炎合并肺部感染具有重要价值。
Objective: To investigate the clinical diagnostic value of hematological indexes in predicting severe acute pancreatitis complicated with pulmonary infection. Methods: Patients with severe acute pancreatitis who underwent treatment in our hospital from January 2013 to June 2015 were selected as study subjects. Patients were divided into non-infected group and infected group according to whether the patients had pulmonary infection. The levels of TNF-α, IL-10, CRP and procalcitonin in the two groups were detected and compared. Results: In this study, 48 cases were enrolled in non-infected group and 45 cases in infected group. The level of TNF-α, CRP and procalcitonin in infected patients were significantly higher than those in non-infected patients (P <0.05). ROC curve analysis showed that the sensitivity and specificity of TNF-α for the diagnosis of severe acute pancreatitis secondary to pulmonary infection were 80.00%, 85.42% and 0.83, respectively, with a cut-off value of 21.44 ng / L. The results were excellent In CRP, procalcitonin. Conclusions: TNF-α, CRP and procalcitonin are reliable indicators for the diagnosis of severe acute pancreatitis complicated with pulmonary infection. Among them, TNF-α is highly specific and sensitive. In the prediction of severe acute pancreatitis complicated with lung Department of Infection has important value.