Procalcitonin strip test in the early detection of severe acute pancreatitis
Procalcitonin strip test in the early detection of severe acute pancreatitis
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DOI：
10.1046/j.1365-2168.2001.01673.x
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发表时间：
2001-02-01
影响因子：
9.6
通讯作者：
Repo, H
中科院分区：
文献类型：
--
作者：
Kylänpää-Bäck, ML;Takala, A;Repo, H
工作背景：早期识别随后发展为重症急性胰腺炎的患者将能够选择可能受益于早期强化管理的患者。由于重症急性胰腺炎的特点是全身炎症的发展，作者研究了是否降钙素原，全身炎症的标志物，区分轻度和重度急性胰腺炎患者。在入院时和24小时后，通过快速，采用免疫比浊法对162例急性胰腺炎患者进行PCT（R）-Q半定量检测和血清C反应蛋白（CRP）测定。重症38例，轻型124例。结果：PCT（R）-Q试验预测重症急性胰腺炎的准确性（24 h敏感性92%，特异性84%）高于CRP、APACHE Ⅱ评分和兰森评分。其阴性预测值高（97%，在24小时），它检测到每个病人谁随后发生器官衰竭（n = 22）。结论：PCT（R）-Q试验是一个有用的筛选方法检测重症急性胰腺炎。它是简单和快速执行，不像目前可用的多因素评分系统，可以很容易地采用到常规的临床实践。
Background: Early identification of patients who subsequently develop severe acute pancreatitis would enable the selection of patients who may benefit from early intensive management. Because severe acute pancreatitis is characterized by the development of systemic inflammation the authors studied whether procalcitonin, a marker of systemic inflammation, differentiated between patients with mild and severe acute pancreatitis.Methods: On admission and 24 h thereafter, serum procalcitonin level was measured by a rapid, semiquantitative PCT(R)-Q test and serum C-reactive protein (CRP) by an immunoturbidimetric method in a consecutive series of 162 patients with acute pancreatitis. There were 38 severe and 124 mild cases. The accuracy of procalcitonin and CRP in predicting severe acute pancreatitis was compared with that of Ranson and Acute Physiology and Chronic Health Evaluation (APACHE) II scores.Results: The PCT(R)-Q test was more accurate in predicting severe acute pancreatitis (sensitivity 92 per cent and specificity 84 per cent at 24 h) than CRP, APACHE II score and Ranson score. Its negative predictive value was high (97 per cent at 24 h), and it detected each patient who developed subsequent organ failure (n = 22).Conclusion: The PCT(R)-Q test was a useful screening method for detecting severe acute pancreatitis. It is simple and quick to perform and, unlike currently available multiple factor scoring systems, can easily be adopted into routine clinical practice.