The Value Of C-reactive Protein In Predicting Severity And Prognosis Of Acute Pancreatitis In Acute Inflammatory Response Phase

OBJECTIVE: To estimate the value of C-reactive protein in predicting of severity and prognosis of acute pancreatits by observing the dynamic change of the C-reactive protein level in severe acute pancreatitis.METHODS: 74 patients with acute pancreatitis from May,2006 to April,2007 were included in the study. The C-reactive protein concentration in serum were measured on day 1,2,3,5,7 after admission and the day before discharge. Contrast-enhanced computed tomograghy was used in the severe acute pancreatitis. According to the severity of the disease, the occurrence of pancreatic necrosis and the occurrence of organ failure, patients were divided into two groups separately. Average C-reactive protein values were compared between groups by t test for unpaired data. The difference was assumed statistically significant when P<0.05. A receiver operating characteristic(ROC) curve analysis was used to explore the relationship between the sensitivity and specificity of prognostic indices in determining disease severity. An index of the goodness of the test is the area under the curve; a perfect test has area 1.0, while a non-discriminating test has area 0.5RESULTS: The C-reactive protein concentrations were significant elevated in all the patients with acute pancreatitis. The C-reactive protein concentrations were starting to decreased gradually as soon as they reached the peak points on day3 after admission in the survivors while the high level of the C-reactive protein concentrations in serum lasted for a long time in the dead cases; The difference of average C-reactive protein concentration were significant between groups (P <0.05). C-reactive protein is an important predictive marker of occurrence of pancreatic necrosis on day2 after admission, and it can predict the severity and systemic and local complications of acute pancreatitis since day3 after admission.CONCLUSIONS:The results of our study show that the C-reactive protein level in acute inflammatory response phase is an important predictive maker of severity and prognosis of acute pancreatitis. C-reactive protein is an early important predictive marker of occurrence of systemic and local complications .