摘要
目的比较降钙素原和CK、CK-MB对早期诊断绞窄性肠梗阻的临床价值。方法对我院2009年1月至2012年2月135例不同类型机械性肠梗阻患者联合检测血清降钙素原和CK及其同工酶CK-MB,比较单纯性不完全性肠梗阻和绞窄性肠梗阻患者及对照组血清中降钙素原和CK、CK-MB浓度变化。结果单纯性不完全性肠梗阻组血清中降钙素原或CK、CK-MB与对照组比较,差异均无统计学意义(P>0.05)。在绞窄性肠梗阻组患者中,肠缺血组患者降钙素原浓度高于单纯性不完全性肠梗阻组(P<0.05);肠坏死组血清中降钙素原浓度高于肠缺血组,两组比较差异有统计学意义(P<0.05);绞窄性肠梗阻中肠坏死组患者血清中降钙素原浓度明显高于单纯性不完全性肠梗阻组(P<0.01)。在绞窄性肠梗阻组患者中,肠缺血组的患者血清中CK、CK-MB浓度与单纯性不完全性肠梗阻组比较,差异无统计学意义(P>0.05);肠坏死组血清中CK、CK-MB高于肠缺血组,两组比较差异有统计学意义(P<0.05)。降钙素原和CK、CK-MB诊断绞窄性肠梗阻的敏感度分别为91.11%和33.33%,而特异度分别为94.44%和97.77%,降钙素原比CK或其同工酶CK-MB敏感度更高(P<0.01)。结论血清降钙素原反映肠梗阻的严重程度,血清降钙素原比CK、CK-MB具有更高的诊断价值,可以作为临床上早期判断绞窄性肠梗阻的有效指标。
Objective To investigate the value of determination of serum procalcitonin, CK, CK-MB in the early diagnosis of strangulated ileus. Methods Procalcitonin and CK, CK-MB were determined in 135 patients of me- chanical bowel obstruction from Jan. 2009 to Feb. 2012. The levels ofprocalcitonin and CK, CK-MB were compared be- tween patients of strangulated ileus, patients of simple ileus and the control. Strangulated ileus group was further divided into two groups： ischcmic group and necrosis group. Results No significant elevation of procalcitonin or CK, CK-MB in simple ileus group was observed compared with the control group （P〉0.05）. Significant elevation of procalcitonin was found in ischemic group or necrosis group compared with simple ileus group （P〈0.05, P〈0.01）. Significant eleva- tion of procalcitonin was observed in necrosis group compared with ischemic group （P〈0.05）. No significant elevation of CK, CK-MB was observed in ischemic group compared with simple ileus group （P〉0.05）, while significant elevation ofCK, CK-MB was observed in necrosis group compared with simple ileus group （P〈0.05）. The sensitivity ofprocalei- tonin and CK, CK-MB were 91.11% and 33.33%, and the specificity were 94.44% and 97.77%, respectively. The sensi- tivity ofproealcitonin was higher than CK or CK-MB （P〈0.05）. Conclusion The serum procalcitonin correlates close- ly with the severity of ileus. It has a greater value for the early diagnosis of strangulated ileus than CK, CK-MB.
出处
《海南医学》
CAS
2012年第19期12-15,共4页
Hainan Medical Journal
基金
佛山市卫生局立项项目(编号:2011531)
