血清胰蛋白酶是内镜逆行胰胆管造影术后胰腺炎的早期预测指标。

IF 3.2 3区 医学 Q2 GASTROENTEROLOGY & HEPATOLOGY
Takashi Tamura, Reiko Ashida, Tomoya Emori, Masahiro Itonoga, Yasunobu Yamashita, Keiichi Hatamaru, Yuki Kawaji, Hiromu Koutani, Takao Maekita, Masayuki Kitano
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The primary outcome was the diagnostic abilities of TRY levels measured immediately (0 h-TRY) and 2 h after (2 h-TRY) ERCP to predict PEP (compared with the other serum pancreatic enzymes).</p><p><strong>Results: </strong>Of 130 patients analyzed, 18 developed PEP. The sensitivity and specificity of 0 h-TRY were 83.3% and 69.6%, respectively, and those of 2 h-TRY were 88.9% and 72.3%, respectively. The area under the curve (AUC) for 0 h-TRY was significantly higher than that for 0 h-AMY (p = .006) and 0 h-P-AMY (p = .012), whereas the AUCs for 0 h-TRY and 0 h-LIP did not differ significantly (p = .563). The AUC for 2 h-TRY for predicting PEP was significantly higher than that for 2 h-AMY (p = .025), whereas there was no significant differences between the AUCs for 2 h-TRY and 2 h-P-AMY(p = .146), or between those for 2 h-TRY and 2 h-LIP (p = .792). 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引用次数: 0

摘要

背景:ERCP术后2-6小时测量的血清淀粉酶(AMY)水平可预测ERCP术后胰腺炎(PEP)。胰蛋白酶是 PEP 发病过程中升高的胰腺酶之一。该研究评估了血清胰蛋白酶(TRY)能否预测早期胰腺炎:这项前瞻性研究纳入了 2022 年 6 月至 2023 年 5 月期间接受 ERCP 的患者。ERCP术后立即和2小时后测量TRY、AMY、血清胰腺AMY(P-AMY)和血清脂肪酶(LIP)水平。主要结果是ERCP后立即(0 h-TRY)和2 h后(2 h-TRY)测量的TRY水平预测PEP的诊断能力(与其他血清胰酶相比):结果:在分析的 130 例患者中,18 例出现了 PEP。0 h-TRY 的灵敏度和特异性分别为 83.3% 和 69.6%,2 h-TRY 的灵敏度和特异性分别为 88.9% 和 72.3%。0 h-TRY 的曲线下面积(AUC)明显高于 0 h-AMY (p = .006) 和 0 h-P-AMY (p = .012),而 0 h-TRY 和 0 h-LIP 的曲线下面积差异不大 (p = .563)。2 h-TRY 预测 PEP 的 AUC 明显高于 2 h-AMY (p = .025),而 2 h-TRY 和 2 h-P-AMY 的 AUC(p = .146)以及 2 h-TRY 和 2 h-LIP 的 AUC(p = .792)之间没有明显差异。在ERCP术后立即检测的所有血清胰酶中,TRY的中位增加比(以相对于基线的比率表示)最高(TRY、AMY、P-AMY和LIP分别为5.35、1.72、1.94和4.44):结论:ERCP术后立即检测TRY有助于早期预测PEP。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Serum trypsin as an early predictor of post-endoscopic retrograde cholangiopancreatography pancreatitis.

Background: Serum amylase (AMY) levels measured 2-6 h after ERCP are a predictor of post-ERCP pancreatitis (PEP). Trypsin is one of the pancreatic enzymes elevated in the development of PEP. The study assessed whether serum trypsin (TRY) can predict early-stage PEP.

Methods: This prospective study included patients who underwent ERCP from June 2022 to May 2023. TRY, AMY, serum pancreatic AMY (P-AMY), and serum lipase (LIP) levels were measured immediately after ERCP and 2 h later. The primary outcome was the diagnostic abilities of TRY levels measured immediately (0 h-TRY) and 2 h after (2 h-TRY) ERCP to predict PEP (compared with the other serum pancreatic enzymes).

Results: Of 130 patients analyzed, 18 developed PEP. The sensitivity and specificity of 0 h-TRY were 83.3% and 69.6%, respectively, and those of 2 h-TRY were 88.9% and 72.3%, respectively. The area under the curve (AUC) for 0 h-TRY was significantly higher than that for 0 h-AMY (p = .006) and 0 h-P-AMY (p = .012), whereas the AUCs for 0 h-TRY and 0 h-LIP did not differ significantly (p = .563). The AUC for 2 h-TRY for predicting PEP was significantly higher than that for 2 h-AMY (p = .025), whereas there was no significant differences between the AUCs for 2 h-TRY and 2 h-P-AMY(p = .146), or between those for 2 h-TRY and 2 h-LIP (p = .792). The median increase ratio (expressed as a ratio relative to baseline) in TRY was highest among all of serum pancreatic enzymes tested immediately after ERCP (5.35, 1.72, 1.94, and 4.44 for TRY, AMY, P-AMY, and LIP, respectively).

Conclusion: Measuring TRY immediately after ERCP is useful for the early prediction of PEP.

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来源期刊
Journal of Hepato‐Biliary‐Pancreatic Sciences
Journal of Hepato‐Biliary‐Pancreatic Sciences GASTROENTEROLOGY & HEPATOLOGY-SURGERY
自引率
10.00%
发文量
178
审稿时长
6-12 weeks
期刊介绍: The Journal of Hepato-Biliary-Pancreatic Sciences (JHBPS) is the leading peer-reviewed journal in the field of hepato-biliary-pancreatic sciences. JHBPS publishes articles dealing with clinical research as well as translational research on all aspects of this field. Coverage includes Original Article, Review Article, Images of Interest, Rapid Communication and an announcement section. Letters to the Editor and comments on the journal’s policies or content are also included. JHBPS welcomes submissions from surgeons, physicians, endoscopists, radiologists, oncologists, and pathologists.
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