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目的探讨血浆胰蛋白酶原激活肽(trypsinogen activation peptide,TAP)水平与重症急性胰腺炎(severe acute pancreatitis,SAP)胰腺坏死的关系。方法 2008年6月1日-2008年12月31日,采用ELISA法测定本院的35例SAP患者血浆TAP水平,并与胰腺增强CT扫描结果作对比,分析血浆TAP水平与胰腺坏死的关系,以及SAP无胰腺坏死组与SAP胰腺坏死组血浆TAP水平的差异。结果入院时血浆TAP水平预测胰腺坏死的最佳截值点是10.43nmol/mL,其敏感性、特异性、阳性预测值、阴性预测值分别为75%、73.9%、60%、15%,阳性比为2.87,阴性比为0.338。入院第1天血浆TAP水平预测胰腺坏死的最佳截值点是6.91μmol/L,其敏感性、特异性、阳性预测值、阴性预测值分别为90.9%、65.2%、55.6%、6.3%,阳性似然比为2.61,阴性似然比为0.001。SAP胰腺坏死组入院时、入院第一天血浆TAP水平高于SAP无胰腺坏死组(P<0.05)。结论血浆TAP水平变化与SAP病情变化密切相关,病程早期检测血浆TAP水平有助于SAP患者胰腺坏死的预测。
Objective To investigate the relationship between plasma trypsinogen activation peptide (TAP) level and pancreatic necrosis in severe acute pancreatitis (SAP). Methods From June 1, 2008 to December 31, 2008, plasma TAP levels were measured in 35 SAP patients in our hospital by ELISA. Compared with the results of enhanced CT scan, the relationship between plasma TAP levels and pancreatic necrosis was analyzed. And the differences of plasma TAP levels between SAP non-pancreatic necrosis group and SAP pancreatic necrosis group. Results The best cut-off point of predicting pancreatic necrosis at admission was 10.43nmol / mL. The sensitivity, specificity, positive predictive value and negative predictive value were 75%, 73.9%, 60%, 15% The ratio was 2.87 and the negative ratio was 0.338. The best cut-off point of predicting pancreatic necrosis on admission day 1 was 6.91μmol / L, and the sensitivity, specificity, positive predictive value and negative predictive value were 90.9%, 65.2%, 55.6%, 6.3% The positive likelihood ratio was 2.61 and the negative likelihood ratio was 0.001. At SAP admission, the plasma TAP level on the first day of hospital admission was higher than that of SAP group without pancreatic necrosis (P <0.05). Conclusion The change of TAP level in plasma is closely related to the change of SAP. Early detection of plasma TAP level in early course of disease may be helpful for the prediction of pancreatic necrosis in SAP patients.