胰蛋白酶及胰蛋白酶原激活肽在预测急性胰腺炎严重程度中的作用

Trypsin and Trypsinogen Activation Peptide in the Prediction of Severity of Acute Pancreatitis.

作者信息

Allemann Andreas, Staubli Sebastian M, Nebiker Christian A

机构信息

Department of Psychiatry Biel, PZM AG, Vogelsang 84, 2501 Biel, Switzerland.

HPB and Liver Transplantation Service, Royal Free London NHS Foundation Trust, Pond Street, London NW3 QG, UK.

出版信息

Life (Basel). 2024 Aug 23;14(9):1055. doi: 10.3390/life14091055.

DOI:10.3390/life14091055

PMID:39337841

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11433092/

Abstract

OBJECTIVES

To assess the predictive value of serum trypsin and trypsinogen activation peptide (TAP) for the severity of AP through a single center cohort study as well as a systematic review of the current literature.

METHODS

A literature search was conducted using Medline (PubMed), EMBASE and the Cochrane Central Register. A total of 142 patients with acute pancreatitis (AP) were included in the cohort study and parameters of the revised Atlanta criteria of 2012 and the APACHE II were assessed.

RESULTS

The review showed promising results for the predictive value of serum trypsinogen-2 but conflicting results for serum TAP and trypsin. In the cohort study, patients were observed for 4 days after diagnosis of AP; 9 patients had severe AP, 35 patients had moderate AP and 81 patients had mild AP. The ratio of the geometric mean of severe vs. mild AP for trypsin was 0.72 (95% CI: 0.51-1.00), = 0.053 and, for TAP, 0.74 (95% CI: 0.54-1.01), = 0.055, respectively.

CONCLUSIONS

The cohort study showed an inverse correlation of serum levels of TAP and trypsin with severity of AP. Serum TAP and trypsin have an inferior predictive value of severity of AP compared to the clinical APACHE II score.

摘要

目的

通过一项单中心队列研究以及对当前文献的系统评价，评估血清胰蛋白酶和胰蛋白酶原激活肽（TAP）对急性胰腺炎（AP）严重程度的预测价值。

方法

使用Medline（PubMed）、EMBASE和Cochrane中央登记册进行文献检索。队列研究共纳入142例急性胰腺炎（AP）患者，并评估了2012年修订的亚特兰大标准和急性生理与慢性健康状况评分系统II（APACHE II）的参数。

结果

综述显示血清胰蛋白酶原-2的预测价值有前景，但血清TAP和胰蛋白酶的结果存在矛盾。在队列研究中，AP诊断后对患者观察4天；9例为重症AP，35例为中度AP，81例为轻症AP。胰蛋白酶重症与轻症AP的几何平均数之比为0.72（95%CI：0.51-1.00），P=0.053，TAP为0.74（95%CI：0.54-1.01），P=0.055。