杨创杰 张涛 李娟

【摘要】目的探討血清高密度脂蛋白胆固醇（HDLC）、白蛋白（SA）、C反应蛋白（CRP）联合检测对急诊重症胰腺炎患者诊断的影响。方法选取2014年6月～2016年12月收治的47例重症胰腺炎患者设为重症胰腺炎组，同期健康体检者47例设为健康对照组、47例轻度胰腺炎患者设为轻度胰腺炎组，抽取所有受检者血液样本进行检验，统计分析三组血清HDLC、SA、CRP水平及血清各指标单独检测与联合检测对重症胰腺炎的诊断价值。结果重症胰腺炎组血清HDLC、SA水平较健康对照组、轻度胰腺炎组低，血清CRP水平较健康对照组、轻度胰腺炎组高，差异有统计学意义（P<0.01）；联合检测诊断敏感度（93.62%）、准确度（94.33%）较血清HDLC（76.60%、87.23%）、SA（7447%、84.40%）及CRP（78.72%、87.23%）高，差异有统计学意义（P<0.01）；联合检测诊断特异度（94.68%）与血清HDLC（92.55%）、SA（89.36%）及CRP（91.49%）相比，差异无统计学意义（P>0.05）。结论重症胰腺炎患者血清HDLC、SA、CRP水平异常改变，联合检测上述指标水平，可有效提高疾病诊断准确度，减少漏诊和误诊，且能为鉴别病情程度提供一定依据，具有推广价值。

【关键词】HDLC；SA；CRP；急诊重症胰腺炎；诊断效果

中图分类号：R446 文献标识码：ADOI：10.3969/j.issn.10031383.2018.02.021

Effect of combined detection of serum HDLC，SA and

CRP on diagnosis of severe acute pancreatitis

YANG Chuangjie，ZHANG Tao，LI Juan

（Sanmenxia Hospital of Traditional Chinese Medicine，Sanmenxia 472000，China）

【Abstract】ObjectiveTo investigate the effect of combined detection of serum high density lipoprotein cholesterol （HDLC），serum albumin （SA） and Creactive protein （CRP） on the diagnosis of severe acute pancreatitis.MethodsFrom June，2014 to December，2016，47 severe pancreatitis patients admitted to our hospital were selected as severe pancreatitis group，and 47 healthy persons as healthy control group during the same period.Meanwhile，47 patients with mild pancreatitis were selected as mild pancreatitis group.Blood samples were taken from all the subjects for test.And then，the serum levels of HDLC，SA and CRP as well as the diagnostic value of separate detection and combined detection of serum indexes for severe acute pancreatitis in the three groups were statistically analyzed.ResultsSerum levels of HDLC and SA in the severe pancreatitis group were lower than those in the healthy control group and mild the pancreatitis group，and serum levels of CRP were higher than those in the healthy control group and the mild pancreatitis group，so difference was statistically significant（P<0.01）.The sensitivity of the combined detection was 93.62% and accuracy was 94.33%，which was higher than that in the serum HDLC（76.60%，87.23%），the SA（74.47%，84.40%） and CRP（78.72%，87.23%），difference was statistically significant （P<0.01）.There was no statistically significant difference in the diagnostic specificity between the combined detection （94.68%） and serum HDLC （92.55%），SA （89.36%） and CRP （91.49%）（P>0.05）.ConclusionPatients with severe acute pancreatitis has abnormal changes of serum levels of HDLC，SA and CRP.Combined detection of abovementioned indicators can effectively improve the accuracy of disease diagnosis，reduce missed diagnosis and misdiagnosis，and provide a basis for identifying the degree of disease，which is worth popularizing.

【Key words】HDLC；SA；CRP；severe acute pancreatitis；diagnostic effect

重症胰腺炎为消化内科多发疾病，其致病因素较多，包括暴饮暴食、长期饮酒、胆道疾病及高脂血症等，该疾病发病较急，且病情较为复杂。随着生活方式及习惯的转变，重症胰腺炎发病率不断增高，患者多伴有皮下瘀斑、腹膜刺激征、高热、呕吐、恶心、腹胀及腹痛等症状，甚至可发生休克，对其生命健康造成了极大威胁。研究指出，及早确诊并制定对应处理方案，对改善重症胰腺炎临床疗效及预后意义重大[1]。近些年，生化指标检测在重症胰腺炎诊断中的应用价值得到广泛重视，且CRP等指标水平会随疾病病情加剧而发生变化[2]。……