Gurda-Duda Anna, Kuśnierz-Cabala Beata, Nowak Wojciech, Naskalski Jerzy W, Kulig Jan
Department of General and GI Surgery, Faculty of Medicine, Medical College, Jagiellonian University, Kraków, Poland.
Pancreas. 2008 Nov;37(4):449-53. doi: 10.1097/MPA.0b013e3181706d67.
Of patients with acute pancreatitis (AP), 20% develop severe attacks that need early and intensive therapy. Yet, to administer such treatment, it is important to classify early on the patients with mild and severe pancreatitis. The aim of this study was to evaluate the role of serum amyloid A, C-reactive protein, procalcitonin, and routinely measured parameters in the early prediction of the course of AP.
A total of 40 consecutive patients with AP confirmed by computed tomography were prospectively enrolled in the study-29 were graded as mild and 11 were graded as severe. Blood samples were obtained on admission and 24 hours thereafter.
Procalcitonin concentration in both measurements was significantly higher in patients with severe pancreatitis, and the cutoff level was estimated at 0.5 ng/mL. Although serum amyloid A and C-reactive protein levels rose significantly during the period of observation, these were not differentiated between both groups. Among the routinely measured parameters, a prognostic value was found for total calcium concentration, lactic dehydrogenase activity, and glucose concentration.
The best efficiency in the early prediction of severe AP would be achieved with the measurement of procalcitonin, total calcium level, and lactic acid dehydrogenase activity immediately after admission to the ward.
急性胰腺炎（AP）患者中，20%会发展为重症发作，需要早期强化治疗。然而，要进行此类治疗，早期区分轻度和重度胰腺炎患者很重要。本研究的目的是评估血清淀粉样蛋白A、C反应蛋白、降钙素原及常规检测参数在AP病程早期预测中的作用。
通过计算机断层扫描确诊的40例连续AP患者前瞻性纳入本研究，其中29例为轻度分级，11例为重度分级。入院时及此后24小时采集血样。
重度胰腺炎患者两次测量的降钙素原浓度均显著更高，临界值估计为0.5 ng/mL。虽然血清淀粉样蛋白A和C反应蛋白水平在观察期内显著升高，但两组之间无差异。在常规检测参数中，总钙浓度、乳酸脱氢酶活性和葡萄糖浓度具有预后价值。
入院后立即检测降钙素原、总钙水平和乳酸脱氢酶活性，对重症AP的早期预测效率最佳。
