【摘要】 目的:探讨血清抗凝血酶Ⅲ(AT-Ⅲ)联合D-二聚体(D-D)在急性胰腺炎(AP)患者病情严重程度中的预测价值。方法:将75例AP患者根据病情严重程度分为MAP组(轻症AP,28例)、MSAP(中重症AP,25例)及SAP组(重症AP,22例)。检测各组血清AT-Ⅲ、D-D表达水平并比较各组急性生理学与慢性健康状况评分Ⅱ(APACHE Ⅱ)、CT严重程度指数(CTSI)及Ranson评分。结果:不同病情严重程度AP患者血清AT-Ⅲ、D-D表达水平及APACHE Ⅱ、CTSI、Ranson评分比较差异均有统计学意义(P<0.05),MSAP组、SAP组血清AT-Ⅲ表达水平均低于MAP组(P<0.05),而血清D-D表达水平及APACHE Ⅱ、CTSI、Ranson评分均高于MAP组(P<0.05),SAP组血清AT-Ⅲ水平低于MSAP组(P<0.05),而血清D-D表达水平及APACHE Ⅱ、CTSI、Ranson评分均高于MSAP组(P<0.05);AP患者血清AT-Ⅲ与APACHE Ⅱ、CTSI、Ranson评分呈负相关(P<0.05),血清D-D与APACHE Ⅱ、CTSI、Ranson评分呈正相关(P<0.05);血清AT-Ⅲ联合D-D诊断SAP的AUC、敏感度及特异度均优于单一检测,差异均有统计学意义(P<0.05)。结论:血清AT-Ⅲ联合D-D在预测AP患者病情严重程度方面具有重要的预测价值。更多还原

【Abstract】 Objective:To explore the predictive value of serum antithrombin Ⅲ (AT Ⅲ) combined with D-Dimer (D-D) in the severity of acute pancreatitis (AP).Method:A total of 75 AP patients were divided into MAP group (mild AP,28 cases),MSAP group (moderate and severe AP,25 cases) and SAP group (severe AP,22 cases).The serum expression levels of AT-Ⅲ and D-D were measured,and APACHE Ⅱ,CTSI and Ranson scores were given.Result:There were significant differences in the serum levels of AT-Ⅲ,D-D and APACHE Ⅱ,CTSI,Ranson scores in patients with different severity of AP (P<0.05).The serum levels of AT-Ⅲ in the MSAP and SAP group were significantly lower than those in the MAP group (P<0.05),while the serum levels of D-D and APACHE Ⅱ were significantly lower than those in the MSAP and SAP group (P<0.05).The scores of APACHE Ⅱ,CTSI and Ranson in the SAP group were higher than those in the MAP group(P<0.05),while the levels of D-D and APACHE Ⅱ,CTSI and Ranson in the SAP group were significantly lower than those in the MSAP group (P<0.05).The serum AT-Ⅲ in patients with AP had a negative correlation with APACHE Ⅱ,CTSI and Ranson scoring systems (P<0.05).The serum AT-Ⅲ in patients with AP had a positive correlation with APACHE Ⅱ,CTSI and Ranson scoring systems (P<0.05).The AUC,sensitivity and specificity of serum AT-Ⅲ combined with D-D in the diagnosis of SAP were better than those of single detection,the differences were statistically significant (P<0.05).Conclusion:Serum AT-Ⅲ combined with D-D has an important predictive value in predicting the severity of AP patients.更多还原