血清脂肪酸结合蛋白和血钙水平对评估重症胰腺炎急诊手术治疗效果的价值
Value of serum intestinal fatty acid binding protein and calcium levels for evaluating the effect of emergency surgical on the treatment of severe acute pancreatitis
梁晓俊 1钟志越1
作者信息
- 1. 复旦大学附属金山医院 ICU,上海 201508
- 折叠
摘要
目的 研究血清肠型脂肪酸结合蛋白(I-FABP)和血钙水平对评估重症急性胰腺炎(SAP)行急诊手术治疗效果的应用价值.方法 选择2014年6月~2016年10月入复旦大学附属金山医院首次诊断SAP患者共68例,发病时间小于72 h,有急诊内镜或腹腔镜手术指征;分别于术后12 h检测血清I-FABP和血钙水平,记录治疗效果,并采用受试者特征工作曲线(ROC)分析血清I-FABP和血钙单独及联合预测治疗效果的应用价值.结果 68例患者中显效33例,有效21例,无效14例,总有效率79.4%.有效组和无效组间患者性别、年龄、发病时间、APACHEⅡ评分、血淀粉酶、血糖和总胆固醇水平的比较,差异均无统计学意义.有效组术后12 h的血清I-FABP水平均明显低于无效组,血钙水平高于对照组,差异均有统计学意义(P<0.05).ROC分析得出:I-FABP的临界值为368 ng/mL,准确性0.856,敏感性86.5%,特异性92.2%;血钙的临界值为1.96 mmol/L,准确性0.844,敏感性83.5%,特异性86.7%.血清I-FABP和血钙联合检测的ROC分析参数高于两者单独检测.结论 血清I-FABP和血钙联合检测对评估SAP行急诊手术的治疗效果有较好的评估价值.
Abstract
Objective To study the value of serum intestinal fatty acid binding protein(I-FABP) and calcium levels for evaluating the effect of emergency surgical on the treatment of severe acute pancreatitis(SAP). Methods A total of 68 firstly diagnosed as SAP from June 2014 to October 2016 were collected into this study. The arrest time was less than 72 h and they were underwent emergency endoscopic or laparoscopic surgery. The serum I-FABP and calcium levels were detected 12 hours after surgery and analyze the values of serum I-FABP and calcium levels in evaluating the clinical effects by receiver operating characteristic curve(ROC). Results There were 33 cases with excellence, 21 cases with availability and other 14 cases with no-effect, the total efficacy rate was 79.4%. The gender, age, arrest time, APACHE Ⅱ score, derum amylase, blood glucose and total cholesterol levels were no statistical differences in effective group and no-effect group.The serum I-FABP levels 12 hours after surgery in effective group were lower and calcium levels were higher than no-effect group(P<0.05).The evaluating accuracy was 0.856, sensibility was 86.5%,specificity was 92.2%,cut-off value was 368 ng/mL of serum I-FABP by ROC analysis. And they were 0.844,83.5%,86.7% and 1.96 mmol/L of serum calcium level by ROC analysis. Conclusion Serum I-FABP combined with calcium can be used for evaluating the effects of emergency surgical on the treatment of the patients with SAP.
关键词
肠型脂肪酸结合蛋白/血钙/重症急性胰腺炎/急诊内镜/腹腔镜/受试者特征工作曲线Key words
intestinal fatty acid binding protein/calcium/severe acute pancreatitis/emergency endoscopy/laparoscopy/receiver operating characteristic curve引用本文复制引用
出版年
2017
NETL
NSTL
维普
万方数据