内毒素检测对急性胰腺炎诊断价值的研究
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摘要
目的探讨内毒素检测对急性胰腺炎(AP)的临床诊断价值。方法收集该院消化内科2015年10月至2017年3月确诊的AP患者60例,分别采集住院患者48h和96h的血清标本,以及60例正常对照者(对照组)血清标本。采用MB-80微生物快速动态监测法检测所有研究对象的内毒素水平,同时检测血清胰淀粉酶水平,并进行统计分析。结果重症急性胰腺炎(SAP)患者(SAP组)血清内毒素水平在每个时间段均显著高于轻中度急性胰腺炎(MAP)患者(MAP组)和对照组,差异有统计学意义(P<0.05);MAP组又显著高于对照组,差异有统计学意义(P<0.05);SAP组与MAP组血清胰淀粉酶水平比较,差异无统计学意义(P>0.05)。结论内毒素水平可以客观判断AP病情的严重程度。治疗中如果内毒素不下降,患者发展成SAP的风险较大。内毒素可监测和提示SAP的发生,协助临床的诊断。
Objective To evaluate the diagnostic value of endotoxin in patients with acute pancreatitis.Methods The serum of sixty patients with acute pancreatitis who were hospitalized for time 48 hours and 96 hours and 60 healthy cases from October 2015 to March 2017 were collected.The endotoxin was detected by MB-80 microbe kinetic rapid monitoring method.Serum amylase was measured.All the results were analyzed with statistical software SPSS20.0.Results The level of endotoxin of severe acute pancreatitis group in each time period were significantly higher than those of mild acute pancreatitis group and control group,and the differences were statistically significant(P<0.05).The level of endotoxin of mild acute pancreatitis group was significantly higher than that of control group,the difference was statistically significant(P<0.05).There was no significant difference in the level of severe acute pancreatitis group and mild acute pancreatitis group(P>0.05).Conclusion Endotoxin can objectively determine the severity of acute pancreatitis.In the treatment,if endotoxin levels continue to rise,patients are at greater risk of developing severe acute pancreatitis.The detection of endotoxin can monitor and prompt the occurrence of severe acute pancreatitis and assist in clinical diagnosis.
Objective To evaluate the diagnostic value of endotoxin in patients with acute pancreatitis.Methods The serum of sixty patients with acute pancreatitis who were hospitalized for time 48 hours and 96 hours and 60 healthy cases from October 2015 to March 2017 were collected.The endotoxin was detected by MB-80 microbe kinetic rapid monitoring method.Serum amylase was measured.All the results were analyzed with statistical software SPSS20.0.Results The level of endotoxin of severe acute pancreatitis group in each time period were significantly higher than those of mild acute pancreatitis group and control group,and the differences were statistically significant(P<0.05).The level of endotoxin of mild acute pancreatitis group was significantly higher than that of control group,the difference was statistically significant(P<0.05).There was no significant difference in the level of severe acute pancreatitis group and mild acute pancreatitis group(P>0.05).Conclusion Endotoxin can objectively determine the severity of acute pancreatitis.In the treatment,if endotoxin levels continue to rise,patients are at greater risk of developing severe acute pancreatitis.The detection of endotoxin can monitor and prompt the occurrence of severe acute pancreatitis and assist in clinical diagnosis.
引文
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[8]WARSHAW A L.Improving the treatment of necrotizing pancreatitis-a step up[J].N Engl J Med,2010,362(16):1535-1537.
[9]张起鹏,王丽芳,张朋伟.重症急性胰腺炎患者高迁移率族蛋白B1的变化及其与多器官功能障碍综合征的关系[J].河北医药,2010,32(14):1841-1843.
[10]谭超超,朱燕,罗文婷,等.内毒素在急性胰腺炎早期炎症反应中的作用[J].中国卫生检验杂志,2016,18(7):974-977.
[2]李婕琳.重症急性胰腺炎死亡危险因素的预测分析[J].山西医药杂志(下半月版),2013,42(14):811-814.
[3]VASILIADIS K,PAPAVASILIOU C,AL-NIMER A,et al.The role of opennecrosectomy in the current management of acute necrotizing pancreatitis:a review article[J].ISRN Surg,2013,13(7)435-438.
[4]中华医学会外科学分会胰腺外科学组.急性胰腺炎治疗指南[J/CD].中华普通外科学文献(电子版),2015,9(2):86-89.
[5]郝惠琼.浅谈45例重症急性胰腺炎患者的诊断与治疗[J].求医问药(学术版),2012,10(5):276-276.
[6]董秀鹏.血清淀粉酶和脂肪酶联合检测在急性胰腺炎诊断中的应用[J].国际检验医学杂志,2015,35(5):655-656.
[7]秦学军.血清淀粉酶和脂肪酶联合测定在急性胰腺炎诊断中的意义[J].中国实用医药,2013,28(7):44-45.
[8]WARSHAW A L.Improving the treatment of necrotizing pancreatitis-a step up[J].N Engl J Med,2010,362(16):1535-1537.
[9]张起鹏,王丽芳,张朋伟.重症急性胰腺炎患者高迁移率族蛋白B1的变化及其与多器官功能障碍综合征的关系[J].河北医药,2010,32(14):1841-1843.
[10]谭超超,朱燕,罗文婷,等.内毒素在急性胰腺炎早期炎症反应中的作用[J].中国卫生检验杂志,2016,18(7):974-977.