Division of Gastroenterology, Department of Medicine, Buddhist Dalin Tzu Chi General Hospital, Chiayi, Taiwan.
Pancreas. 2011 Nov;40(8):1211-4. doi: 10.1097/MPA.0b013e31821fcdcf.
The aim of this prospective study was to evaluate the diagnostic value of the rapid urinary trypsinogen-2 test strip in post-endoscopic retrograde cholangiopancreatography (ERCP) pancreatitis.
A total of 150 patients were tested with the urinary trypsinogen-2 test strip and serum levels of amylase and lipase before ERCP and 3 hours after ERCP. The diagnostic value of urinary trypsinogen-2 strip test compared with that of serum amylase and lipase was analyzed.
Post-ERCP pancreatitis was diagnosed in 13 (8.7%) of 150 patients. The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of urinary trypsinogen-2 dipstick test at 3 hours after ERCP are 84.6%, 97.1%, 73.3%, 98.5%, and 96%, respectively. At the cutoff level of 3 times the upper reference limit, the negative predictive values of amylase and lipase were comparable to that urinary trypsinogen-2 strip test; however, their positive predictive values (42.9% and 36.4%, respectively) were markedly lower than that of urinary trypsinogen-2 test (73.3%).
The urinary trypsinogen-2 dipstick test is a useful test for early diagnosis of post-ERCP pancreatitis. A negative urinary dipstick test at 3 hours after the procedure rules out post-ERCP pancreatitis with a high probability and allows of early discharge plan.
本前瞻性研究旨在评估快速尿胰蛋白酶原-2 检测条在经内镜逆行胰胆管造影术（ERCP）后胰腺炎中的诊断价值。
对 150 例患者在 ERCP 前和 ERCP 后 3 小时进行尿胰蛋白酶原-2 检测条和血清淀粉酶和脂肪酶检测。分析尿胰蛋白酶原-2 条检测与血清淀粉酶和脂肪酶的诊断价值。
150 例患者中诊断为 ERCP 后胰腺炎 13 例（8.7%）。尿胰蛋白酶原-2 条检测在 ERCP 后 3 小时的敏感性、特异性、阳性预测值、阴性预测值和准确性分别为 84.6%、97.1%、73.3%、98.5%和 96%。在 3 倍上界的截断值时，淀粉酶和脂肪酶的阴性预测值与尿胰蛋白酶原-2 条检测相当；然而，它们的阳性预测值（分别为 42.9%和 36.4%）明显低于尿胰蛋白酶原-2 检测（73.3%）。
尿胰蛋白酶原-2 条检测是诊断 ERCP 后胰腺炎的有用检测方法。在操作后 3 小时进行阴性尿条检测可高度排除 ERCP 后胰腺炎，并可制定早期出院计划。
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