血清 P–AMY、TNF–α 水平对急性坏死性 胰腺炎预后判断的价值

Value of Serum P-AMY and TNF-α Levels in Predicting the Prognosis of Acute Necrotizing Pancreatitis

摘要:

〔摘 要〕 目的：探究血清胰淀粉酶（P–AMY）、肿瘤坏死因子 –α（TNF–α）水平对急性坏死性胰腺炎预后的预测价值。 方法：选取 2014 年 2 月至 2019 年 10 月厦门大学附属中山医院收治的急性坏死性胰腺炎患者 108 例作为观察组，并选 取同期 108 例体检健康者作为对照组。急性坏死性胰腺炎患者随访 28 d，按照预后情况分为存活组（89 例）及死亡组 （19 例）。比较不同研究对象的血清 P–AMY、TNF–α 水平；采用受试者工作特征曲线（ROC）评价血清 P–AMY、TNF–α 对急性坏死性胰腺炎患者预后的预测价值。 结果：观察组患者血清 P–AMY、TNF–α 水平均明显高于对照组；死亡组患者 血清 P–AMY、TNF–α 水平均明显高于存活组，差异均具有统计学意义（P ＜ 0.05）。ROC 曲线分析结果显示，P–AMY、 TNF–α 对急性坏死性胰腺炎患者预后的预测价值均较高，联合预测的价值高于两者单独预测。 结论：急性坏死性胰腺炎患 者血清 P–AMY、TNF–α 水平均明显升高，检测血清 P–AMY、TNF–α 水平有助于临床判定急性坏死性胰腺炎患者预后。

Abstract:

〔Abstract〕 Objective To explore the value of serum pancreatic amylase (P-AMY) and tumor necrosis factor-α (TNF-α) levels in predicting the prognosis of acute necrotizing pancreatitis. Methods A total of 108 patients with acute necrotizing pancreatitis admitted to Zhongshan Hospital Affiliated to Xiamen University from February 2014 to October 2019 were selected as the observation group, and 108 healthy people who underwent physical examination during the same period were selected as the control group. The patients with acute necrotizing pancreatitis were followed up for 28 days, and were divided into the survival group (89 cases) and the death group (19 cases) according to the prognosis. The levels of serum P-AMY and TNF-α were compared between the two groups; the predictive value of serum P-AMY and TNF-α levels in predicting the prognosis of patients with acute necrotizing pancreatitis was evaluated using the receiver operating characteristic curve (ROC). Results The levels of serum P-AMY and TNF-α in the observation group were significantly higher than those of the control group (P < 0.05); the levels of serum P-AMY and TNF-α in the death group were significantly higher than those of the survival group (P < 0.05). ROC curve analysis results showed that P-AMY and TNF-α had high predictive value for the prognosis of patients with acute necrotizing pancreatitis, and the combined prediction value was higher than that of the two alone. Conclusion The levels of serum P-AMY and TNF-α in patients with acute necrotizing pancreatitis are obviously increased. Detection of serum P-AMY and TNF-α levels is helpful to determine the prognosis of patients with acute necrotizing pancreatitis.