专业性胰腺功能异常:先进诊断的透视指标

Н.Р. Кербаж, Сергій Панасенко
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引用次数: 0

摘要

介绍急性胰腺炎(AP)是最常见的消化系统疾病之一,需要住院治疗。到目前为止,AP早期的分层和鉴别诊断问题仍未解决,这鼓励人们寻找诊断和预测AP严重程度的新方法。目标根据疾病持续时间和AP严重程度的微循环动态变化,评估建立AP分层和预后临床导向系统的可能性。材料和方法。采用“LAK-02”型激光多普勒血流仪对患者的微循环(MC)状态进行评估。在比较独立样本时,使用Kruskal-Wallis非参数方差分析和中位数检验来检验统计假设。使用Mann-Whitney U检验对独立样本进行配对比较。后果该研究确定了不同AP严重程度患者在发病第一天的MC指标。轻度、中度和重度AP患者的微循环参数(MP)为3.9;3.8和6.8灌注单位(p.u.)。血流量调节率(ơ)为0.52;轻度、中度和重度AP分别为0.54和0.69 p.u。在我们的研究中,变异系数(Kv)平均为17.3%;轻度、中度和重度AP患者分别为20.0%和11.7%。结论。AP中的LDF是诊断MC状态的一种信息方法,MC是生物体所有病理生理反应中的一个普遍环节。AP MC的变化取决于AP的严重程度和病程。发病第一天发现的病理生理微循环现象为我们提供了早期临床区分中度和重度AP与所谓的“破坏性AP”的视角。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
ПЕРФУЗІЙНА ДИСФУНКЦІЯ ПРИ ГОСТРОМУ ПАНКРЕАТИТІ: ПЕРСПЕКТИВНІ НАПРЯМКИ УДОСКОНАЛЕННЯ ДІАГНОСТИКИ ТА СТРАТИФІКАЦІЇ ЗАХВОРЮВАННЯ
Introduction. Acute pancreatitis (AP) is one of the most common diseases of the digestive system that require hospitalization. To date, the problem of stratification and differential diagnosis of AP in the early stages remains unresolved, which encourages the search for new methods of diagnosis and prediction of the severity of AP. Aim. To evaluate the possibility of creating a clinically oriented system of stratification and prognosis of AP on the basis of dynamic changes in microcirculation depending on the duration of the disease and severity of AP. Materials and methods. Assessment of the state of microcirculation (MC) of patients by laser Doppler flowmetry (LDF) was performed with the “LAKK-02” device. Kruskal-Wallis non-parametric analysis of variance and the median test were used to test statistical hypotheses when comparing independent samples. Pairwise comparison of independent samples was performed using the Mann-Whitney U test. Results. The study determined the indicators of MC in patients with different AP severity degrees on the first day of the disease. The microcirculation parameter (MP) in patients with mild, moderate, and severe AP was 3.9; 3.8 and 6.8 perfusion units (p.u.), respectively. The blood flow modulation rate (ơ) was 0.52; 0.54 and 0.69 p.u. in mild, moderate, and severe AP. In our study, the coefficient of variation (Kv) averaged 17.3%; 20.0% and 11.7% in patients with mild, moderate, and severe AP, respectively. Conclusions. LDF in AP is an informative method of diagnosing the state of MC, which is a universal link in all pathophysiological reactions of the organism. Changes of MC in AP depend on the severity of AP and the period of the disease. The pathophysiological microcirculatory phenomena, revealed on the first day of the disease, provide us with the perspectives of early clinical distinguishing the moderate and severe forms of AP from the so-called group of “destructive forms”.
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