Cevik Yunsur, Kavalci Cemil, Ozer Mehmet, Daş Murat, Kiyak Gülten, Ozdoğan Mehmet
Department of Emergency Medicine, Atatürk Training and Research Hospital, Ankara, Turkey.
Ulus Travma Acil Cerrahi Derg. 2010 Mar;16(2):125-9.
The aim of the study was to investigate the role and importance of the urine trypsinogen-2 dipstick test in the differential diagnosis of acute pancreatitis in the Emergency Department and to compare results with those of conventional tests.
The study was performed prospectively in the patients admitting to the Emergency Department due to upper abdominal pain. Thirty-two of the 87 patients included in the study had acute pancreatitis diagnosis. Serum amylase, lipase, C-reactive protein (CRP) and urine trypsinogen-2 using Actim pancreatitis dipstick were studied in all patients. The statistical analysis was performed using SPSS 11.5 package program.
Urine trypsinogen-2 was found positive in 21 (65.6%) of 32 patients. The sensitivity of the test for pancreatitis was identified as 64%, specificity as 85%, positive predictive value as 72%, and negative predictive value as 81%. These values were statistically significant compared to the control group (p<0.01).
Although it has lower sensitivity and specificity compared to amylase and lipase, we suggest that urine trypsinogen-2 test may be an important diagnostic tool in excluding the diagnosis of acute pancreatitis, since it provides results within 5 minutes in the Emergency Department, is cheaper, has a higher negative predictive value, and is easy to use.
本研究旨在探讨尿胰蛋白酶原-2试纸检测在急诊科急性胰腺炎鉴别诊断中的作用及重要性，并将结果与传统检测方法进行比较。
对因上腹部疼痛入住急诊科的患者进行前瞻性研究。纳入研究的87例患者中，32例诊断为急性胰腺炎。对所有患者检测血清淀粉酶、脂肪酶、C反应蛋白（CRP）以及使用Actim胰腺炎试纸检测尿胰蛋白酶原-2。使用SPSS 11.5软件包进行统计分析。
32例患者中21例（65.6%）尿胰蛋白酶原-2呈阳性。该检测对胰腺炎的敏感性为64%，特异性为85%，阳性预测值为72%，阴性预测值为81%。与对照组相比，这些值具有统计学意义（p<0.01）。
尽管与淀粉酶和脂肪酶相比，尿胰蛋白酶原-2检测的敏感性和特异性较低，但我们认为该检测可能是排除急性胰腺炎诊断的重要诊断工具，因为它在急诊科5分钟内即可得出结果，成本较低，阴性预测值较高，且易于使用。
