胰腺炎相关蛋白作为急性胰腺炎的早期标志物。

Pancreatitis associated protein as an early marker of acute pancreatitis.

作者信息

Kemppainen E, Sand J, Puolakkainen P, Laine S, Hedström J, Sainio V, Haapiainen R, Nordback I

机构信息

Second Department of Surgery, Helsinki University Central Hospital, Finland.

出版信息

Gut. 1996 Nov;39(5):675-8. doi: 10.1136/gut.39.5.675.

DOI:10.1136/gut.39.5.675

PMID:9026481

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC1383390/

Abstract

BACKGROUND

Measuring serum pancreatitis associated protein (PAP) in acute pancreatitis has proved valuable to monitoring the course of the disease and the recovery of the patient.

AIMS

The aim was to analyze the utility of PAP on admission as a diagnostic and prognostic marker of acute pancreatitis.

PATIENTS

Values of PAP were prospectively analyzed in 80 healthy volunteers, 164 patients with abdominal pain but without pancreatitis, 109 patients with mild acute pancreatitis, and 38 patients with severe acute pancreatitis.

METHODS

The diagnosis of acute pancreatitis was verified with clinical, laboratory, radiological, and in some cases findings at operation or necropsy.

RESULTS

Mean (95% confidence intervals) serum PAP values were 27 (24 to 29) micrograms/l in healthy volunteers, 78 (59 to 96) micrograms/l in patients with abdominal pain, 191 (134 to 247) micrograms/l, in patients with mild acute pancreatitis, and 599 (284 to 914) micrograms/l in patients with severe acute pancreatitis. Differences between the groups were significant (p = 0.04 - 0.01). Despite the differences in means, the ranges overlapped between the groups. The sensitivity of PAP on admission to detect acute pancreatitis was 38%-53% and the respective specificity 89%-77% depending on the cut off level. The sensitivity of PAP to detect severe acute pancreatitis was 45%-68% and the specificity 74%-59% depending on the cut off level.

CONCLUSIONS

Admission PAP did not distinguish severe from mild acute pancreatitis better than C reactive protein. Measurement of PAP does not give appreciable diagnostic advantages in the early phase of acute pancreatitis.

摘要

背景

在急性胰腺炎中，检测血清胰腺炎相关蛋白（PAP）已被证明对监测疾病进程及患者康复情况具有重要价值。

目的

分析入院时PAP作为急性胰腺炎诊断和预后标志物的效用。

患者

前瞻性分析了80名健康志愿者、164名有腹痛但无胰腺炎的患者、109名轻度急性胰腺炎患者及38名重度急性胰腺炎患者的PAP值。

方法

通过临床、实验室、影像学检查，部分病例结合手术或尸检结果来确诊急性胰腺炎。

结果

健康志愿者血清PAP均值（95%可信区间）为27（24至29）μg/L，腹痛患者为78（59至96）μg/L，轻度急性胰腺炎患者为191（134至247）μg/L，重度急性胰腺炎患者为599（284至914）μg/L。各组间差异有统计学意义（p = 0.04 - 0.01）。尽管均值存在差异，但各组范围有重叠。根据临界值水平，入院时PAP检测急性胰腺炎的敏感性为38% - 53%，特异性为89% - 77%。根据临界值水平，PAP检测重度急性胰腺炎的敏感性为45% - 68%，特异性为74% - 59%。