Comparison of serum procalcitonin with Ranson, APACHE-II, Glasgow and Balthazar CT severity index scores in predicting severity of acute pancreatitis.
Comparison of serum procalcitonin with Ranson, APACHE-II, Glasgow and Balthazar CT severity index scores in predicting severity of acute pancreatitis.
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DOI：
10.4166/kjg.2011.58.1.31
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发表时间：
2011-07
影响因子：
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通讯作者：
Su Mi Woo;M. Noh;Byung Geun Kim;C. Hsing;Ji sun Han;Seung Hee Ryu;Jeong Min Seo;H. Yoon;J. Jang;S. Choi;J. Cho
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文献类型：
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作者：
Su Mi Woo;M. Noh;Byung Geun Kim;C. Hsing;Ji sun Han;Seung Hee Ryu;Jeong Min Seo;H. Yoon;J. Jang;S. Choi;J. Cho
背景/目的本研究的目的是评估血清降钙素原(PCT)在重症急性胰腺炎早期预测中的作用，并与多种评分系统和生物标志物进行比较。方法对44例经放射学、实验室检查和临床表现证实的急性胰腺炎患者进行前瞻性研究。所有的血样和影像检查都是在入院24小时内取得的。结果急性胰腺炎按Atlanta分级标准，重度19例，轻度25例。重症急性胰腺炎患者血清PCT水平明显升高(P=0.001)。血清PCT作为预测指标的准确率为77.3%，与急性生理学和慢性健康检查(APACHE)-II评分相近，低于Ranson评分(93.2%)，优于Balthazar CT指数(65.9%)。血清PCT值的最有效界值为1.77 ng/mL(AUC=0.797，95%CI=0.658~0.935)。与其他简单的生物标志物相比，血清PCT的准确率(77.3%)高于C反应蛋白(68.2%)、尿素(75.0%)和乳酸脱氢酶(72.7%)。Logistic回归分析显示，血清PCT在急性重症胰腺炎中有统计学意义。对血清PCT水平和住院天数进行一元线性回归分析，有效p值为低R平方，仅可能影响入院天数(R2=0.127，P=0.021)。结论血清PCT是一种有前景的简单生物标志物，APACHE-II评分预测急性胰腺炎严重程度的准确性与APACHE-II相似。
BACKGROUND/AIMS The aim of this study is to assess serum procalcitonin (PCT) for early prediction of severe acute pancreatitis compared with multiple scoring systems and biomarkers. METHODS Forty-four patients with acute pancreatitis confirmed by radiological evidences, laboratory assessments, and clinical manifestation were prospectively enrolled. All blood samples and image studies were obtained within 24 hours of admission. RESULTS Acute pancreatitis was graded as severe in 19 patients and mild in 25 patients according to the Atlanta criteria. Levels of serum PCT were significantly higher in severe acute pancreatitis (p=0.001). The accuracy of serum PCT as a predicting marker was 77.3%, which was similar to the acute physiology and chronic health examination (APACHE)-II score, worse than the Ranson score (93.2%) and better than the Balthazar CT index (65.9%). The most effective cut-off level of serum PCT was estimated at 1.77 ng/mL (AUC=0.797, 95% CI=0.658-0.935). In comparision to other simple biomarkers, serum PCT had more accurate value (77.3%) than C-reactive protein (68.2%), urea (75.0%) and lactic dehydrogenase (72.7%). Logistic regression analysis revealed that serum PCT has statistical significance in acute severe pancreatitis. Assessment of serum PCT levels and length of hospital stay by simple linear regression analysis revealed effective p-value with low R square level, which could make only possibilty for affection of serum PCT to admission duration (r2=0.127, p=0.021). CONCLUSIONS Serum PCT was a promising simple biomarker and had similar accuracy of APACHE-II scores as predicting severity of acute pancreatitis.