小儿急性胰腺炎的实验室诊断研究进展

小儿急性胰腺炎诊断及预测其严重程度的传统实验室指标包括血、尿淀粉酶,血脂肪酶,尿胰蛋白酶原-2,C反应蛋白,淀粉酶和肌酐清除比率以及细胞因子等.传统实验室诊断指标操作简便、经济,但敏感性和特异性不够理想.近年来降钙素原、磷脂酶A2、胰酶试剂盒、胰蛋白酶原活性肽、羧肽酶B活性肽、人胰腺特异蛋白/羧肽酶原B、多形核白细胞弹性蛋白酶、血清淀粉样蛋白A及细胞间黏附分子1等新的实验室指标被相继发现和应用,为小儿急性胰腺炎的早期诊断和病情严重程度预测提供了可靠的判断方法,但新的实验室诊断指标多数检测繁琐、价格昂贵,限制了其在临床的广泛应用.因此,仍需寻找更敏感、特异、廉价和可操作性强的实验室指标应用于临床诊断.

Progress of laboratory diagnosis of acute pancreatitis in children

The traditional laboratory markers of acute pancreatitis in children include serum amylase and urine amylase, serum lipase, urinary trypsinogen-2, C-reactive protein, cytokines, amylase and creatinine clearance ratio and so on. They can be simply detected and economic, but the sensitivity and specificity are not satisfied. Several new laboratory markers of acute pancreatitis in children, which include procalcitonin, phospholipase A2, PankrinTM, trypsinogen activation peptide, carboxypeptidase B activation peptide, human pancreas-specific protein/procarboxypeptidase B, polymorphonuclear elastase, serum amyloid protein A, and as well as intercellular adhesion molecule- 1, have been found and applied in recent years .They can provide reliable judgment methods for early diagnosis and prediction of the severity of acute pancreatitis in children, but most of the new laboratory markers are rarely used in clinic because they are difficult to be detected and expensive. More sensitive, specific, cheap and operable laboratory markers which can be used in clinic are to be explored.