血清生化标志物对急性胆源性胰腺炎的预测作用

Ramesh Baral, Ramila Shrestha, B. Thapa, K. Khanal
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摘要

急性胰腺炎(AP)是最常见的需要住院的胃肠道疾病。在AP的病因中,胆结石(45%)和酗酒(20%)是最常见的原因。从2021年7月至2022年6月,对69名符合纳入标准的AP患者进行了评估。评价血清生化指标丙氨酸转氨酶(ALT)对急性胆源性胰腺炎的预测作用,以及血清生化指标(ALT、天冬氨酸转氨酶、碱性磷酸酶、胆红素、淀粉酶和脂肪酶水平)对急性胆源性胰腺炎的预测作用。共纳入69例诊断为AP的患者。男性46例(66.7%),女性23例(33.3%),其中诊断为胆道性胰腺炎12例(17.3%),非胆道性胰腺炎57例(82.7%)。在非胆源性胰腺炎中,男性41例,女性16例。非胆道性胰腺炎多见于男性,胆道性胰腺炎多见于女性。胆源性胰腺炎和非胆源性胰腺炎的淀粉酶平均水平无显著差异(即非胆源性胰腺炎;平均±SD = 387.14±419.53,胆源性胰腺炎平均±SD = 535.5±533.51,p值= 0.235 >0.05),胆源性胰腺炎和非胆源性胰腺炎的平均脂肪酶无显著差异(即非胆源性胰腺炎;平均±SD=1287.75±894.37,胆源性胰腺炎平均±SD= 1666.41±1150.47,p值=0.289 > 0.05)。其他各项指标(胆红素T&D、ALT、AST、ALP)的平均水平在胆源性和非胆源性胰腺炎中均有显著性差异(p值=0.000<0.05)。以ALT为主的肝功能检测可预测AP的胆道病因。
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The predictivity of serum biochemical markers in acute biliary pancreatitis
Acute pancreatitis (AP) is the most common gastrointestinal disease requiring hospital admission. Among the etiology of AP gallstones (45%) and alcohol abuse (20%) are the most frequent causes of AP. Sixty-nine patients of AP who met the inclusion criteria were evaluated from July 2021- June 2022. The predictivity of serum biochemical marker alanine transaminase (ALT) in acute biliary pancreatitis and the mean serum biochemical markers (ALT, aspartate transaminase, alkaline phosphatase, bilirubin, amylase and lipase level) in AP were evaluated. Total 69 patients with the diagnosis of AP were included. Forty-six (66.7%) were male and twenty-three (33.3%) were female out of which 12 (17.3%) were diagnosed as biliary pancreatitis and 57 (82.7%) had non-biliary pancreatitis. In non-biliary pancreatitis there were 41 male and 16 females. Non-biliary pancreatitis was more common in male and biliary pancreatitis was more common in female. There was no significant difference in mean levels of amylase in biliary and non-biliary pancreatitis (i.e. in non-biliary pancreatitis; mean ± SD = 387.14 ± 419.53, in biliary pancreatitis mean ± SD = 535.5 ± 533.51, p-value= 0.235 >0.05), the mean lipase was not significantly different in biliary and non-biliary pancreatitis (i.e.in non biliary pancreatitis; mean ± SD=1287.75±894.37, in biliary pancreatitis mean ± SD =1666.41 ± 1150.47, p-value =0.289 > 0.05). There was a significant difference seen among the mean levels of all other parameters (Bilirubin T&D, ALT, AST and ALP) the mean was found to be significant in biliary and non-biliary pancreatitis (i.e. p-value=0.000<0.05). Liver function test mainly ALT may predict biliary etiology of AP.
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