摘要
目的:探讨急性重症胰腺炎(SAP)患者早期血清降钙素原(PCT)与肠道功能之间的关系。方法:SAP患者21例为SAP组,16例急性脑血管病患者为对照组。各组患者入ICU时行APACHEⅡ、Marshall及肠功能评分。收集患者入ICU后3d内的血、痰、尿、引流物标本行细菌学检查。检测入ICU时血清PCT及D-乳酸浓度,同时对PCT与肠功能评分、D-乳酸进行相关性分析,并评价PCT对SAP合并肠功能障碍的诊断价值。结果:SAP组入ICU的3d内仅2例合并细菌感染。SAP组APACHEⅡ、Marshall及肠功能评分、D-乳酸及PCT均较对照组显著增加(均P<0.01)。PCT与D-乳酸、肠功能评分呈显著正相关(均P<0.01),PCT≥2.25ng/L时预测SAP合并肠功能障碍的价值最好。结论:SAP早期血清PCT即升高,PCT升高与肠道功能障碍(渗透性增加)密切相关。
Objective To investigate the association of procalcitonin （PCT） and gut function in the early stage of severe acute pancreatitis （SAP）. Methods 21 patients with SAP were assigned to SAP group and 16 patients with acute cerebrovascular diseases were served as control. Scores of APACHE Ⅱ, Marshall, and gut function was calculated on ICU admission. Samples of blood, sputum, urine, draining fluid were collected for bacteriological examinations on Days 1 to 3 of admission. Serum levels of PCT and D-lactase were detected. The association among PCT, D-lactase, and gut function was analyzed; and the diagnostic value of PCT for SAP with gut dysfunction was assessed. Results Only two patients with SAP were found to have bacterial infection within three days after admission. As compared with the control group, scores of APACHE Ⅱ, Marshall, and gut function and levels of PCT and D-lactase were significantly increased in the SAP group （P 〈 0.01 for all comparisons）. PCT was positively related with D-lactase and gut function score （P 〈 0.01 for all comparisons）. PCT ≥2.25 ng/L had the greatest value in predicting SAP with gut dysfunction. Conclusions Serum PCT level is increased in the early stage of SAP, which is closely related with gut dysfunction （hyperpermeability）.
出处
《实用医学杂志》
CAS
北大核心
2009年第14期2254-2257,共4页
The Journal of Practical Medicine
基金
广州市科委攻关引导项目(编号:03Z3-E0261)
