论文部分内容阅读
目的探讨血浆和肽素水平与重症急性胰腺炎(severe acute pancreatitis,SAP)患者临床预后的关系。方法收集2012年1月~2014年10月于我科就诊的SAP患者48例的临床资料,并选取同期于我院行健康体检的患者48例作为对照组。比较两组患者血浆和肽素的水平。实验组患者入院后24 h内行APACHEⅡ、Ranson及改良Marshall评分以评价SAP疾病严重程度及MODS发生情况。记录实验组患者胰腺及胰周组织积液、坏死,胰腺及胰周脓肿、胰腺假性囊肿及MODS等局部或全身性并发症发生情况,患者住院期间病死情况,分析血浆和肽素水平与SAP患者并发症发生情况及病死率间的关系。结果实验组血浆和肽素水平为(0.83~5.49)ng/ml,平均(3.48±1.32)ng/ml;对照组血浆和肽素水平为(009~1.46)ng/ml,平均(0.23±0.06)ng/ml。组间比较差异有统计学意义(P<0.05)。和肽素水平高的患者局部并发症、MODS发生率较高,病死率较高,组间比较差异有统计学意义(P<0.05)。血浆和肽素水平预测SAP患者病死风险的约登指数为>4.02 ng/m1,其敏感性和特异性分别为72.7%和81.0%(AUC=0.831,95%CI=1.051~1.679,P<0.001)。结论 SAP患者血浆和肽素表达水平升高,高和肽素水平预示患者并发症、病死风险较高。
Objective To investigate the relationship between plasma copeptin levels and clinical prognosis in patients with severe acute pancreatitis (SAP). Methods The clinical data of 48 patients with SAP who were treated in our department from January 2012 to October 2014 were collected, and 48 patients who underwent physical examination in our hospital during the same period were selected as the control group. Plasma copeptin levels were compared between the two groups. Patients in the experimental group underwent APACHEⅡ, Ranson and modified Marshall scores within 24 hours after admission to evaluate the severity of SAP disease and the occurrence of MODS. The experimental group patients with pancreatic and peri-pancreatic tissue effusion, necrosis, pancreatic and pancreatic abscess, pancreatic pseudocyst and MODS and other local or systemic complications, the patient died during hospitalization, analysis of plasma copeptin levels and SAP The incidence of patient complications and the relationship between mortality. Results The plasma copeptin level in the experimental group was (0.83 ~ 5.49) ng / ml, with an average of (3.48 ± 1.32) ng / ml and the plasma copeptin level was (009 ~ 1.46) ng / ) ng / ml. The difference between the two groups was statistically significant (P <0.05). Local co-morbidity of patients with high copeptin levels was associated with a higher incidence of MODS and higher mortality, with significant differences between the two groups (P <0.05). The Youden index of plasma and copeptin levels predicting the risk of mortality in patients with SAP was> 4.02 ng / m1 with a sensitivity and specificity of 72.7% and 81.0%, respectively (AUC = 0.831, 95% CI = 1.051-1.679, P <0.001 ). Conclusions The plasma copeptin levels in patients with SAP are elevated. High copeptin levels predict the patient’s complication and the risk of death is high.