The Study On The Correlation Between Serum Procalcitonin And Disease Progression In Patients With Acute Pancreatitis

Background: Acute pancreatitis(AP)as a common abdominal emergency,can be caused by gallstones,alcohol and other factors,making the enzym in the pancreas activated,and then make the pancreatic tissue cells digesting themselves.[2] Clinical manifestations often accompanied by nausea and vomiting,acute upper abdominal pain,which cannot be alleviated after vomiting.The 2012 Atlanta revision standard provides clinicians with a new classification that is different from previous standards,except that most of the previous grading criteria can be self-healing mild acute pancreatitis(MAP)and have higher Mortality,severe acute pancreatitis(SAP),adding a new grade of mild primary acute pancreatitis(MSAP),as well as a series of improved diagnostic and Grading standards,which can be more systematic,meticulous and scientific.Procalcitonin(PCT)as a clinical epidemic in recent years,an inflammatory detection index,in the clinical practice of the process gradually reflects its advantages in high specificity and high sensitivity.History of PCT discovery dates back to 1981 and was reported in 1993 by ASSICOT et al.in Lancet magazine for a case of bacterial infection in patients with a marked increase in PCT.The PCT began to enter the clinician's vision and gradually became Inflammation detection and differential diagnosis of essential indicators.Objective: To collect the percentage of AP patients at all levels of AP within 48 hours after admission,and to compare the difference in PCT concentration between three groups was statistically significant or not.According to the 2012 Atlanta guidelines.It aims to identify the severity of MSAP and SAP in early stage after admission,and to prevent the development of patients with SAP in order to improve the quality and efficiency of treatment and improve the prognosis of patients.Methods: 103 patients were divided into MAP group(n = 34),MSAP group(n = 35)and SAP group(n = 34)according to the latest Atlanta guidelines.Make sure that the gender ratio between groups is substantially equal to the age distribution.The PCT concentration was measured by SPSS 22.0 within 48 hours after admission,in order to compare the difference of PCT concentration between the three groups were significant,and the recommended PCT diagnostic threshold was obtained according to the reference interval of each group.Results: The PCT concentration in the MAP group was not significantly different from that in the MSAP group(p = 0.024,which reached the ? = 0.05 standard,but did not reach the corrected ? '= 0.0167 standard).The PCT concentration in the MAP group has a significant difference(p = 0)between the SAP group.The PCT concentration in the MSAP group makes a significant difference(p=0.001)between the SAP group.Using PCT> 0.435 ng / ml as the standard for the early differential diagnosis of SAP,has a sensitivity of 91.2% and specificity of 63.8%.Conclusion: According to the 2012 revised Atlanta standard,organ failure can be found in MSAP and SAP patients after admission.But it is difficult to determine the exact severity,because they do not know whether the patient will develop to persistent organ failure,or temporary failure.So 48 hours have become the window period of the diagnosis.From this study,PCT> 0.435 ng / ml can be used as a standard for early diagnosis of SAP in clinical.The sensitivity of 91.2% in the early stage can help to discover the possibility of developing to SAP and prepare as soon as possible,in case that it progresses to SAP after 48 hours.