Significance of procalcitonin in judgment of disease situation of acute pancreatitis / 中国中西医结合急救杂志

ABSTRACT

Objective To approach the significance of procalcitonin(PCT)in judgment of the degree of severity in patients with acute pancreatitis(AP). Methods A prospective method was conducted in the study. Ninety-eight patients with AP admitted from April 2013 to December 2013 in the First Affiliated Hospital of Zhengzhou University were enrolled. They were divided into mild AP(MAP,48 cases)and severe AP(SAP,50 cases)groups, biliary AP(58 cases)and non biliary AP(40 cases)groups,and biliary SAP and biliary MAP groups,non biliary SAP and non biliary MAP groups. The venous blood levels of PCT on the first day and second day after admission were assayed for all the patients,and the correlations between PCT levels on the two time points respectively and each of the following items were calculatedRanson score,acute physiology and chronic health evaluation Ⅱ(APACHE Ⅱ)score,CT grade,number of organ dysfunction,intensive care unit(ICU)time of stay and total time of hospitalization. Results On the second day after admission,the PCT levels in groups different in etiology and groups different in severity were all elevated and higher than those on the first day,the level in SAP group being significantly higher than that of MAP group〔3.723(2.538,9.023)vs. 0.282(0.166,1.348),P0.05〕,the level in biliary SAP group being higher than that in biliary MAP group〔4.023(3.273,10.015)vs. 0.305 (0.244,1.413),P<0.01〕,and the level in non biliary SAP group being higher than that in non biliary MAP group〔3.624(2.454,8.993)vs. 0.256(0.144,1.137),P<0.01〕. The correlations between PCT levels on the first day and second day after admission and each of the following items were respectively as followsthe correlations with Ranson score〔relative risk (RR1)=0.643,P1=0.001,95% confidence interval(95%CI1)0.435-1.596;RR2=0.762, P2=0.001,95%CI20.692-1.541〕,APACHE Ⅱ score(RR1=0.543,P1=0.009,95%CI10.842-1.512;RR2=0.672,P2=0.001,95%CI20.747-1.234)and CT grade(RR1=0.231,P1=0.048,95%CI10.596-1.412;RR2=0.256,P2=0.032,95%CI20.702-1.324)were all positive;the higher the number of organ dysfunction,the higher the level of PCT(RR1=0.321,P1=0.023,95%CI10.763-2.588;RR2=0.389,P1=0.020,95%CI20.683-1.742);the level of PCT had relatively favorable correlation with ICU time of stay(RR1=0.423,P1=0.019,95%CI10.779-1.459;RR2=0.453,P2=0.010,95%CI20.684-1.853),but there was no correlation between the level and the total time of hospitalization(RR1=0.004,P1=0.067,95%CI10.864-2.071;RR2=0.009,P2=0.078,95%CI20.645-1.376). Conclusion The level of PCT can be used in judgment of the degree of severity of the patients with AP,not only it can be applied in patients biliary in origin,but also can be used in patients non biliary in origin.