诊断急性胰腺炎的生化检测指标评析

目的通过检测血淀粉酶（S-Amy）、胰脂肪酶（LPS）、C反应蛋白（CRP）及尿淀粉酶（U—Amy）、尿胰蛋白酶原激活肽（TAP）5项生化指标，探讨急性胰腺炎（AP）早期诊断及病情评估的有效指标。方法将541例急腹症患者分为AP组和非AP组，其中AP组分为轻症AP（MAP）和重症AP（SAP），同时选取80例健康体检者作为正常对照组，于患者人院后6h内采集静脉血并留取新鲜尿液，对各组5项生化指标进行检测和分析。S-Amy,U—Amy、LPS采用速率法，TAP、CRP采用EusA法。结果S-Amy、U—Amy和TAP水平在AP组最高，非AP组次之，正常对照组最低，各组之间差异均具有统计学意义（P〈0．01）。AP组LPS水平较非AP组及正常对照组显著增高（P〈0．01）。AP组与非AP组CRP水平均较正常对照组增高（P〈0．01），但AP组CRP水平与非AP组比较无显著差异。SAP组U—Amy、TAP及CRP水平显著高于MAP组（P〈0．01），而S-Amy、LPS水平在这两组间无显著差异（P〉0．05）。LPS用于AP早期诊断的敏感度为92．1％、特异度为91．6oA，显著高于S—Amy、U—Amy、TAP及CRP。结论血、尿淀粉酶、LPS指标对于AP的早期诊断具有重要意义，TAP和CRP有助于评估病变的严重程度、观察疗效及评估预后。

Analysis of biochemical detection index for diagnosis of acute pancreatitis

Objective To explore the effective indicators for early diagnosis and condition assessment of acute pan- creatitis （AP） by detecting five biochemicals： serum amylase （S-Amy）, pancreatic lipase （LPS）,C-reactive protein （CRP） and urine amylase （U-Amy） ,urinary trypsinogen activation peptide （TAP）. Methods 541 cases of acute abdo- men patients were divided into AP group and non AP group,AP group is divided into mild AP （MAP） and intensive AP （SAP） ,and 80 cases of healthy subjects were served as normal control group. Fresh blood and urine were collected from patients within 6 hours after admission and the five biochemical indexes were detected for further analysis. S- Amy,U-Amy and LPS were detected by rate method and TAP and CRP were detected by ELISA method. Results S1 Amy,U-Amy and TAP levels in AP group were the highest, those in Non-AP group were higher and those in normal control group were the lowest, the difference has statistics significance （P〈0.01）. LPS level in AP group were signifi- cantly higher than those in Non-AP group and normal control group（P〈0.01） ,the CRP level in AP group and Non-AP group were higher than those in normal control group（P〈0.01）. But the levels in AP group and non-AP group were not significantly different. U-Amy, TAP and CRP levels in SAP group were significantly higher than those in MAP group （P〈0.01） ,while S-Amy,LPS levels between the two groups had no significantly difference（P〉0.05）. The sen- sitivity of LPS for AP early diagnosis was 92.1 % and the specificity was 91.6 %, which is significantly higher than that of S-Amy,U-Amy,TAP and CRP. Conclusion The LPS index is helpful to the early diagnosis of AP,TAP and CRP are helpful in the assessment of lesions and observation of efficacy and prognostic.