摘要
目的:用ROC曲线评价白介素-6(interleukin-6,IL-6)早期诊断重症急性胰腺炎的临床价值。方法:收集96例急性腹痛患者的肝素锂抗凝血浆各1ml置-20℃。根据其后的临床诊断资料将病人分为三组:非胰腺炎急腹症50例,重症急性胰腺炎17例,轻症急性胰腺炎29例。相同方法收集50份各项指标正常的体检标本。用DGGR底物连续监测法测定脂肪酶(lipase,LPS),用DPCIMMULITE化学发光法测定IL-6,用ROC曲线评价LPS和IL-6的早期诊断重症急性胰腺炎的临床价值。结果:用LPS鉴别诊断非胰腺炎性急腹症和急性胰腺炎时,cutoff值取94U/L,灵敏度(Se)=0.98,特异性(Sp)=0.98,AUC=0.998,LPS能较好的鉴别诊断非胰腺炎性急腹症和急性胰腺炎。用IL-6鉴别诊断重症急性胰腺炎和轻症急性胰腺炎时,cutoff值取11pg/ml,Se=1.00,Sp=0.86,AUC=0.925,IL-6能较好的鉴别诊断重症急性胰腺炎和轻症急性胰腺炎。结论:DGGR底物连续监测法测定LPS和DPCIMMULITE化学发光法测定IL-6,不仅提高了灵敏度和特异性,而且加快了检测速度,确保了LPS和IL-6的准确及时报告,促进了临床的广泛应用。LPS和IL-6结合使用对早期诊断重症急性胰腺炎有较高的临床价值。
Objective The clinical applicability of measuring serum IL -6 levels for early diagnosis of severe acute pancreatitis was assessed with ROC curve. Methods Serum lipase （with biochemistry） and IL -6 （with CLIA） levels were measured in 50 patients with non -pancreatitis acute abdomen, 17 patients with severe acute pancreatitis, 29 patients with mild acute pancreatitis upon arrival at emergency room as well as in 50 controls. Results The levels of serum lipase were significantly higher in patients with acute panereatitis than those in patients with non - pancreatitis acute abdomen. Taking 94U/L as cutoff value, the diagnostic sensitivity was 0. 98, specificity was 0. 98, AUC （under ROC curve） was 0. 998, therefore, serum lipase levels was very useful for differentiation of pancreatitis from non -pancreatitis. Serum IL -6 value was much higher in patients with severe acute pancreatitis than those in patients with mild acute pancreatitis. Taking 11 pg/ml as catoff value, the diagnostic sensitivity was 1.00, specificity was 0. 86, AUC was 0. 925, therefore, serum IL - 6 level was very useful for differentiating severe acute pancreatitis from mild acute pancreatitis. Conclusion Combined determination of serum lipase and IL - 6 levels was very helpful for establishing the diagnosis of pancreatitis as well as for determining the type of acute pancreatitis. The methods used in our laboratory （ DGGR substrate continous monitoring for serum lipase and CLIA for IL- 6） proved to be sensitive, accurate, and expedient.
出处
《放射免疫学杂志》
CAS
2007年第3期260-262,共3页
Journal of Radioimmanology
关键词
急性胰腺炎
脂肪酶
白介素-6
ROC曲线
acute pancreatitis, lipase （LPS）, interleukin -6 （IL-6）, ROC curve
