The Significance Of Dynamic Monitoring α₁-acid Glycoprotein And High-sensitivity C-reactive Protein To Assess The Severity Of Acute Pancreatitis In The Early Stages

Objective: To explore the clinical value the dynamic monitoring of serumα1-acid glycoprotein (α1-AGP) and high-sensitive C-reactive protein (HsCRP) to assess the severity of acute pancreatitis (AP) in the early stage.Methods: To collect 74 cases of patients with AP which medical datas were complete, the diagnosis and classification of AP in strict accordance with the diagnost- ic criteria of the"Acute pancreatitis Clinical guidelines of United States of America", which 51 cases were mild acute pancreatitis (MAP), 23 cases were severe acute pancreatitis (SAP), all patients were hospitalized within 24h of onset, and were the first attack. MAP group and SAP group patients at post-admission 1 h, 24 h, 3 d, 5 d, 7 d and discharged from hospital were detected serum HsCRP andα1-AGP, and at post-admission 24 h, 3 d received APACHEⅡscoring and Balthazar CT scoring.Results: In the 74 cases of AP have been observed, the serumα1-AGP concentrations were began to increase in SAP group at post-admission 1 h, and it reached peak in post-admission 3rd, after a gradual decline. Serumα1-AGP at the same period between SAP group and MAP group were statistically significant difference (P<0.05), when discharged from hospital two groupsα1-AGP concentrations were no significant difference (P>0.05). The concentrations of HsCRP in all AP patients were increased during hospitalization. All AP patients during hospitalization. At post-admission 24 h, the concentrations of serum HsCRP between SAP group and MAP group were statistically significant difference (P<0.05), At post-admission 3, 5 and 7rd, the concentrations of serum HsCRP of SAP group were significantly higher than the MAP group patients (P<0.01). When discharged from hospital two groups serum HsCRP near normal levels (normal 0-6 mg/L). The changes in MAP group during hospitalization between serumα1-AGP and HsCRP were positive correlation (correlat- eion coefficient r, 0.823, P<0.05). The changes in SAP group during hospitalization between serumα1-AGP and HsCRP were also positive correlation (correlation coefficient r, 0.907, P<0.05). At post-admission 3rd, APACHEⅡscore (12.7±2.7) in SAP group was higher than the MAP group (6.5±1.5), difference was statistically significant (P<0.01). At post-admission 3rd, CT score (4.0±0.7), in SAP group was higher than the MAP group (2.5±0.7), difference was statistically significant (P<0.05). Serumα1-AGP concentrations detected in AP patients at post-admission 24 h to assess AP severity and APACHEⅡscore had a better goodness of fit (Kappa value, 0.748, P<0.01), Serumα1-AGP and HsCRP concentrations detected in AP patients at post-admission 3rd to assess AP severity and APACHEⅡscore have an excellent goodness of fit (Kappa values, 0.815 and 0.848, respectively, P<0.01).Conclusions: This study methods are more desirable, Application of Serumα1-AGP and HsCRP have a high degree of accuracy of diagnosis SAP, it can be used as a new reference index outside of APACHEⅡscore and CT score, and its simple, highly sensitive, are a more desirable indicators in early distinguish the clinical types of AP. AP patients at post-admission are monitoring dynamically join serumα1-AGP and HsCRP levels contribute to assess the severity of the disease, to diagnosis establishment of SAP in early,so that severe patients received intensive care as soon as possible, to guide clinicians make reasonable the best treatment, Clinical applications of serumα1-AGP and HsCRP to utilize rationally the medical resources have a very important significance.