【摘要】 目的探究E-Cadherin、血液淀粉酶同工酶P3亚型及胰脂肪酶对急性胰腺炎病情变化的预测价值。方法选取2018年6月至2019年6月我院收治的符合标准的急性胰腺炎患者80例,依据指南将所有AP患者分为轻型组(MAP组,n=40)和重型组(SAP组,n=40),比较两组患者血清中E-Cadherin、AMY-P3、胰脂肪酶的定量及Ranson评分和APACHE II评分;采用SPSS中ROC曲线方法推算出血清中E-Cadherin、AMY-P3、胰脂肪酶对重症胰腺炎的早期诊断价值;采用Pearson相关分析进行分析血清中E-Cadherin、AMY-P3、胰脂肪酶与Ranson评分和APACHE II评分的相关性。结果 SAP组中的E-Cadherin、AMY-P3、胰脂肪酶明显高于MAP组,差异有统计学意义(P<0.05)。SAP组患者的Ranson评分和APACHE II评分明显高于MAP组,差异有统计学意义(P<0.05);血清中E-Cadherin、AMY-P3、胰脂肪酶三个指标联合检测诊断SAP的敏感度为76.90%,特异度为80.50%,ROC曲线下面积为0.850(95%CI:0.768-0.932,P<0.001)诊断价值优于单项检测;血清中E-Cadherin、AMY-P3、胰脂肪酶与Ranson评分均呈正相关,并互为正相关(P<0.05)。结论 E-Cadherin、AMY-P3、胰脂肪酶联合检测对评估急性胰腺炎的严重程度具有较好的早期预测价值,可作为评估重症胰腺炎早期预后的重要指标之一。更多还原

【Abstract】 Objective To investigate the predictive value of E-Cadherin,P3 subtype of blood amylase isoenzyme,and pancreatic lipase for changes in the condition of acute pancreatitis. Methods A total of 80 patients with acute pancreatitis who met the criteria and were admitted to our hospital from June 2018 to June 2019 were selected and divided into the mild group(MAP group,n=40) and the severe group(SAP group,n=40)according to the guidelines.The quantification of serum E-cadherin,AMY-P3, pancreatic lipase,Ranson score,and APACHE II score were compared between the two groups.The ROC curve method in SPSS was used to deduce the early diagnostic value of serum E-cadherin,AMY-P3,and pancreatic lipase for severe pancreatitis. Pearson correlation analysis was used to analyze the correlation between serum E-cadherin,AMY-P3,pancreatic lipase,and Ranson score,and APACHE II score. Results E-Cadherin,AMY-P3,and pancreatic lipase in the SAP group were significantly higher than those in the MAP group,and the differences were statistically significant(P<0.05).The Ranson score and APACHE II score of patients in the SAP group were significantly higher than those in the MAP group,and the differences were statistically significant(P<0.05).The sensitivity,specificity,and area under the ROC curve of combined detection of E-Cadherin,AMY-P3,and pancreatic li pase in serum for the diagnosis of SAP were 76.90%,80.50%,and 0.850,respectively(95% CI:0.768-0.932,P<0.001).The diagnostic value of the combined detection was better than that of the single detection.E-Cadherin,AMY-P3,and pancreatic lipase in serum were positively correlated with Ranson score,and positively correlated with each other(P<0.05). Conclusion The combined detection of E-Cadherin,AMY-P3,and pancreatic lipase has a good early predictive value for evaluating the severity of acute pancreatitis.It can be used as one of the important indicators for evaluating the early prognosis of severe pancreatitis.更多还原